Provider Demographics
NPI:1093835035
Name:VERNE A. SCHWAGER, M.D., S.C.
Entity Type:Organization
Organization Name:VERNE A. SCHWAGER, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERNE
Authorized Official - Middle Name:ARCHIBALD
Authorized Official - Last Name:SCHWAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-392-5580
Mailing Address - Street 1:2025 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4152
Mailing Address - Country:US
Mailing Address - Phone:847-392-5580
Mailing Address - Fax:847-378-8311
Practice Address - Street 1:1009 S EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3144
Practice Address - Country:US
Practice Address - Phone:847-392-5580
Practice Address - Fax:847-392-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-31
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-042940207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C39539Medicare UPIN
IL470270Medicare PIN