Provider Demographics
NPI:1699797274
Name:NOVAK, ROBERT CHESTER (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHESTER
Last Name:NOVAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9535 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66111
Mailing Address - Country:US
Mailing Address - Phone:913-788-7300
Mailing Address - Fax:913-788-9679
Practice Address - Street 1:9535 STATE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66111
Practice Address - Country:US
Practice Address - Phone:913-788-7300
Practice Address - Fax:913-788-9679
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS14265014OtherBLUE CROSS BLUE SHIELD KC
KSQ242721Medicare ID - Type Unspecified