MEDICARE: DR. STEVEN LEE VANDEN HOEK 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	111N00000X	Chiropractor	2003003457	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	178826	OTHER	MO	BCBS
2	541944	OTHER	IL	HEALTHLINK
3	541944	OTHER	MO	HEALTHLINK
4	9532009	OTHER	IL	BCBS OF ILLINOIS

General Provider Information

NPI Number	:	1699778308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN LEE VANDEN HOEK D.C.

Provider Business Mailing Address
First Line	:	2201 S BRENTWOOD BLVD STE 103
Second Line	:
City	:	BRENTWOOD
State	:	MO
Zip	:	63144-1847
Country	:	US
Telephone Number	:	314-667-8864
Fax Number	:	314-717-0010

Provider Business Practice Location Address
First Line	:	2201 S BRENTWOOD BLVD STE 103
Second Line	:
City	:	BRENTWOOD
State	:	MO
Zip	:	63144-1847
Country	:	US
Telephone Number	:	314-667-8864
Fax Number	:	314-717-0010

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	02/07/2017

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