Healthcare Provider Details

I. General information

NPI: 1649655861
Provider Name (Legal Business Name): ERIC R SCHAID DC SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 10/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MIDWEST RD 100E
OAK BROOK IL
60523-1342
US

IV. Provider business mailing address

2021 MIDWEST RD 100E
OAK BROOK IL
60523-1342
US

V. Phone/Fax

Practice location:
  • Phone: 815-900-6150
  • Fax:
Mailing address:
  • Phone: 815-900-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number038.012851
License Number StateIL

VIII. Authorized Official

Name: ERIC RYAN SCHAID
Title or Position: OWNER
Credential: D.C.
Phone: 815-900-6150