Provider Demographics
NPI:1518011774
Name:SCHOUTEN, ERIC (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SCHOUTEN
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 1:148 CONCORD LN
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2698
Mailing Address - Country:US
Mailing Address - Phone:630-841-6202
Mailing Address - Fax:
Practice Address - Street 1:641 N YORK ST
Practice Address - Street 2:SUITE B
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-1604
Practice Address - Country:US
Practice Address - Phone:630-841-6202
Practice Address - Fax:630-279-6766
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU78028Medicare UPIN
IL563360Medicare ID - Type Unspecified