Provider Demographics
NPI:1629310339
Name:CLAIRE D. SCHILL DC PA
Entity Type:Organization
Organization Name:CLAIRE D. SCHILL DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:SCHILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-788-7100
Mailing Address - Street 1:480 EAST SR 436
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4911
Mailing Address - Country:US
Mailing Address - Phone:407-788-7100
Mailing Address - Fax:407-339-3526
Practice Address - Street 1:480 STATE ROAD 436
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-4911
Practice Address - Country:US
Practice Address - Phone:407-788-7100
Practice Address - Fax:407-339-3526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 4640111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380298100Medicaid
FL380298100Medicaid
70458Medicare PIN
FL70458Medicare PIN