Provider Demographics
NPI:1407123136
Name:FORGET-SCHNOWSKE, ANDREA KAY (DC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:KAY
Last Name:FORGET-SCHNOWSKE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4812 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-5928
Mailing Address - Country:US
Mailing Address - Phone:309-689-6200
Mailing Address - Fax:309-689-6219
Practice Address - Street 1:4812 N SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-5928
Practice Address - Country:US
Practice Address - Phone:309-689-6200
Practice Address - Fax:309-689-6219
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor