MEDICARE: DR. ELIZABETH ELLA SCHOENEKASE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2008011494	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	512110	OTHER	MO	GHP/COVENTRY
2	724977	OTHER	MO	OPTUMHEALTH
3	9377220	OTHER	MO	AETNA
4	951272	OTHER	MO	HEALTHLINK
5	603626	OTHER	MO	ANTHEM BCBS

General Provider Information

NPI Number	:	1588820575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH ELLA SCHOENEKASE D.C.

Provider Business Mailing Address
First Line	:	PO BOX 96
Second Line	:
City	:	FESTUS
State	:	MO
Zip	:	63028-0096
Country	:	US
Telephone Number	:	636-937-9200
Fax Number	:	636-937-0900

Provider Business Practice Location Address
First Line	:	620 COLLINS DR
Second Line	:
City	:	FESTUS
State	:	MO
Zip	:	63028-2077
Country	:	US
Telephone Number	:	636-937-9200
Fax Number	:	636-937-0900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	01/22/2010

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