Provider Demographics
NPI:1275680522
Name:MICHAEL SCHILL JR DC PC
Entity Type:Organization
Organization Name:MICHAEL SCHILL JR DC PC
Other - Org Name:ELMWOOD PARK CHIRO & PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:201-796-5273
Mailing Address - Street 1:511 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-2038
Mailing Address - Country:US
Mailing Address - Phone:201-796-5273
Mailing Address - Fax:201-796-8645
Practice Address - Street 1:511 BOULEVARD
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-2038
Practice Address - Country:US
Practice Address - Phone:201-796-5273
Practice Address - Fax:201-796-8645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01095700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ081355Medicare ID - Type Unspecified