Healthcare Provider Details

I. General information

NPI: 1598837049
Provider Name (Legal Business Name): MONICA E. SCHNACK D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 JACOBSSEN DR
NORMAL IL
61761-2499
US

IV. Provider business mailing address

2100 JACOBSSEN DR
NORMAL IL
61761-2499
US

V. Phone/Fax

Practice location:
  • Phone: 309-452-9097
  • Fax: 309-452-8269
Mailing address:
  • Phone: 309-452-9097
  • Fax: 309-452-8269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: