Individual
JOHN STEVE VICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
916 TALON DR, STE 102, O FALLON, IL 62269-1848
(618) 628-8211
(618) 628-0883
Mailing address
916 TALON DR, STE 102, O FALLON, IL 62269-1848
(618) 628-8211
(618) 628-0883
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
229688
HEALTHLINK
IL
01
—
5148141
AETNA
IL
01
—
P00107451
MEDICARE RR
IL
Enumeration date
06/22/2005
Last updated
07/08/2007
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