Provider Demographics
NPI:1710069307
Name:SCHELFHOUT, MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:SCHELFHOUT
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 1:3455 W SALT CREEK LN
Mailing Address - Street 2:SUITE #500
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1090
Mailing Address - Country:US
Mailing Address - Phone:847-577-8061
Mailing Address - Fax:847-577-8358
Practice Address - Street 1:3455 W SALT CREEK LN
Practice Address - Street 2:SUITE #500
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1090
Practice Address - Country:US
Practice Address - Phone:847-577-8061
Practice Address - Fax:847-577-8358
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1627852OtherBLUECROSS/BLUESHEILD
IL1627852OtherBLUECROSS/BLUESHEILD
IL910090Medicare ID - Type Unspecified