Provider Demographics
NPI:1205214137
Name:SCHAFFNIT CHIROPRACTIC
Entity Type:Organization
Organization Name:SCHAFFNIT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFFNIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-474-9500
Mailing Address - Street 1:799 ROOSEVELT RD
Mailing Address - Street 2:BLDG. 4 SUITE 103
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:799 ROOSEVELT RD
Practice Address - Street 2:BUILDING SUITE
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5908
Practice Address - Country:US
Practice Address - Phone:630-474-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227013767385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL227013767OtherBCBS