Provider Demographics
NPI:1437469111
Name:SCHAFER, BREANE MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:BREANE
Middle Name:MICHELLE
Last Name:SCHAFER
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 1:1316 D'ADRIAN PROFESSIONAL PARK
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-9719
Mailing Address - Country:US
Mailing Address - Phone:618-467-0300
Mailing Address - Fax:618-467-4065
Practice Address - Street 1:1316 DADRIAN PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035-1685
Practice Address - Country:US
Practice Address - Phone:618-467-0300
Practice Address - Fax:618-467-4065
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011768111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor