Provider Demographics
NPI:1053302372
Name:SCHICHTL, SCOTT E (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:E
Last Name:SCHICHTL
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 1:1678 NATURES WAY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-1706
Mailing Address - Country:US
Mailing Address - Phone:815-978-8037
Mailing Address - Fax:
Practice Address - Street 1:1678 NATURES WAY
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-1706
Practice Address - Country:US
Practice Address - Phone:815-978-8037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007445111NN0400X
WI4861-12111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1669453056OtherFACILITY NPI
IL350054547OtherMEDICARE RAILROAD #
IL1669453056OtherFACILITY NPI
IL350054547OtherMEDICARE RAILROAD #