Healthcare Provider Details
I. General information
NPI: 1982767018
Provider Name (Legal Business Name): RMS DC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4255 N LINCOLN AVE
CHICAGO IL
60618
US
IV. Provider business mailing address
4255 N LINCOLN AVE DR ROBERT STEVENS
CHICAGO IL
60614
US
V. Phone/Fax
- Phone: 773-528-1500
- Fax: 773-528-1919
- Phone: 773-528-1500
- Fax: 773-528-1919
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
ROBERT
MICHAEL
STEVENS
Title or Position: PRESIDENT CEO
Credential: DC
Phone: 773-528-1500