Provider Demographics
NPI:1518183052
Name:SCHWARTZBERG, ERIC SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SCOTT
Last Name:SCHWARTZBERG
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 1:3944 N CLAREMONT AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3855
Mailing Address - Country:US
Mailing Address - Phone:773-267-5663
Mailing Address - Fax:
Practice Address - Street 1:1209 W GRACE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2805
Practice Address - Country:US
Practice Address - Phone:773-551-0023
Practice Address - Fax:773-525-2990
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU80190Medicare UPIN
IL582000Medicare ID - Type Unspecified