Provider Demographics
NPI:1598196180
Name:SNAP SURGICAL RECOVERY
Entity Type:Organization
Organization Name:SNAP SURGICAL RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-650-5653
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-0386
Mailing Address - Country:US
Mailing Address - Phone:847-650-5653
Mailing Address - Fax:
Practice Address - Street 1:13196 W NEMESIS AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60087-3244
Practice Address - Country:US
Practice Address - Phone:847-650-5653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000963253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care