MEDICARE: MR. STEVEN W ZAESKE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NI0900X	Internist Chiropractor	038-008716	IL
2	225100000X	Physical Therapist		IL

General Provider Information

NPI Number	:	1417025784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN W ZAESKE D.C.

Provider Business Mailing Address
First Line	:	18309 DISTINCTIVE DR
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467-9461
Country	:	US
Telephone Number	:	708-479-0020
Fax Number	:	708-479-0094

Provider Business Practice Location Address
First Line	:	918 MADISON ST
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-4474
Country	:	US
Telephone Number	:	630-920-4670
Fax Number	:	630-920-4687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2006
Last Update Date	:	11/29/2017

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