Provider Demographics
NPI:1043286081
Name:SHINHERR, DAVID A (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SHINHERR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 STATION DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7994
Mailing Address - Country:US
Mailing Address - Phone:847-802-7070
Mailing Address - Fax:815-477-5878
Practice Address - Street 1:360 STATION DR STE 100
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014
Practice Address - Country:US
Practice Address - Phone:847-802-7070
Practice Address - Fax:815-477-5878
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008133111N00000X
IL038012345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U59876Medicare UPIN
IL962341114Medicare PIN