MEDICARE: DR. STEVEN G CONNORS DC

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		IL

General Provider Information

NPI Number	:	1891784823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN G CONNORS DC

Provider Business Mailing Address
First Line	:	21 ENGLEWOOD DR
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-4550
Country	:	US
Telephone Number	:	618-355-0942
Fax Number	:

Provider Business Practice Location Address
First Line	:	1518 CAMP JACKSON RD
Second Line	:
City	:	CAHOKIA
State	:	IL
Zip	:	62206
Country	:	US
Telephone Number	:	618-337-5700
Fax Number	:	618-337-7109

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/08/2007

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