Provider Demographics
NPI:1437234176
Name:SCHRIVER, BARBARA JO (DN)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JO
Last Name:SCHRIVER
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 W 123RD ST
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1702
Mailing Address - Country:US
Mailing Address - Phone:708-489-9918
Mailing Address - Fax:798-925-0432
Practice Address - Street 1:6411 W 123RD ST
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1702
Practice Address - Country:US
Practice Address - Phone:708-489-9918
Practice Address - Fax:798-925-0432
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181000157174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633278OtherBCBS
IL181000157OtherLICENSE