Healthcare Provider Details

I. General information

NPI: 1467053918
Provider Name (Legal Business Name): JAKE SCHMITZ CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 FRONTIER PARK DR
O FALLON MO
63366-3963
US

IV. Provider business mailing address

380 BECKLEY PL
SAINT CHARLES MO
63304-1029
US

V. Phone/Fax

Practice location:
  • Phone: 636-379-5934
  • Fax:
Mailing address:
  • Phone: 636-448-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: JACOB SCHMITZ
Title or Position: CHIROPRACTOR
Credential: DC, MS
Phone: 636-448-2644