Provider Demographics
NPI:1235166224
Name:SCHROER, MICHAEL SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SEAN
Last Name:SCHROER
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 1:40 BRIARCLIFF LN
Mailing Address - Street 2:PROFESSIONAL CENTER
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1665
Mailing Address - Country:US
Mailing Address - Phone:815-939-0990
Mailing Address - Fax:815-939-0822
Practice Address - Street 1:40 BRIARCLIFF LN
Practice Address - Street 2:PROFESSIONAL CENTER
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1665
Practice Address - Country:US
Practice Address - Phone:815-939-0990
Practice Address - Fax:815-939-0822
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038003849Medicaid
IL038007503Medicaid
IL350035329OtherRAILROAD MEDICARE NUMBER
IL038003849Medicaid
IL038007503Medicaid