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General NPI Number Information
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NPI Number | 1992913578
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Entity Type | Organization
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Legal Business Name | TOTAL ATHLETICARE SC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 999 N PLAZA DR SUITE 115
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City | SCHAUMBURG
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State | IL
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Zip | 60173-6022
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Country | US
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Telephone | 847-706-9600
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Fax | 847-706-9610
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Provider Business Mailing Address
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Address Line | 999 N PLAZA DR SUITE 115
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City | SCHAUMBURG
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State | IL
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Zip | 60173-6022
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Country | US
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Telephone | 847-706-9600
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Fax | 847-706-9610
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRED SCHUSTER
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Credential | DC
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Telephone | 847-706-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038
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License Number State | IL
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