Provider Demographics
NPI:1609053156
Name:SCHILLINGER, MARK STEVEN (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:STEVEN
Last Name:SCHILLINGER
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 1:119 PAUL DR STE A
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2087
Mailing Address - Country:US
Mailing Address - Phone:415-491-0959
Mailing Address - Fax:415-491-1847
Practice Address - Street 1:119 PAUL DR STE 1
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2086
Practice Address - Country:US
Practice Address - Phone:415-491-0959
Practice Address - Fax:415-491-1847
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 16234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA16234OtherSTATE BOARD OF CHIROPRACTIC EXAMINERS