Healthcare Provider Details

I. General information

NPI: 1477320463
Provider Name (Legal Business Name): MONICA STEPHANS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 12/08/2023
Certification Date: 11/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 EMERSON ST
EVANSTON IL
60201-3131
US

IV. Provider business mailing address

2140 N HALSTED ST APT 4F
CHICAGO IL
60614-4339
US

V. Phone/Fax

Practice location:
  • Phone: 847-869-1773
  • Fax:
Mailing address:
  • Phone: 262-397-7338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number038.014069
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number038.014069
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number038.014069
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.014069
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: