Provider Demographics
NPI:1700845104
Name:SCHOAF, DANIEL PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PATRICK
Last Name:SCHOAF
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 1:210 S 1ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:FORRESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61030-0307
Mailing Address - Country:US
Mailing Address - Phone:815-938-2225
Mailing Address - Fax:815-938-9225
Practice Address - Street 1:210 S 1ST AVENUE
Practice Address - Street 2:
Practice Address - City:FORRESTON
Practice Address - State:IL
Practice Address - Zip Code:61030-0307
Practice Address - Country:US
Practice Address - Phone:815-938-2225
Practice Address - Fax:815-938-9225
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU67332Medicare UPIN
IL362650Medicare ID - Type UnspecifiedMEDICARE
ILL61334Medicare ID - Type Unspecified