=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649470949
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHUSTER CHIROPRACTIC, LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2007
-----------------------------------------------------
Last Update Date | 09/04/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1535 LAKE COOK RD SUITE 204
-----------------------------------------------------
City | NORTHBROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60062-1447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-509-9067
-----------------------------------------------------
Fax | 847-509-9069
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1535 LAKE COOK RD SUITE 204
-----------------------------------------------------
City | NORTHBROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60062-1447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-509-9067
-----------------------------------------------------
Fax | 847-509-9069
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. LISELOTTE SCHUSTER
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 847-509-9067
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 038006484
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------