Provider Demographics
NPI:1801005046
Name:ERIC SCHOUTEN, D.C., S.C.
Entity Type:Organization
Organization Name:ERIC SCHOUTEN, D.C., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-279-7777
Mailing Address - Street 1:PO BOX 270345
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-0345
Mailing Address - Country:US
Mailing Address - Phone:414-529-4180
Mailing Address - Fax:414-858-9082
Practice Address - Street 1:641 N YORK ST
Practice Address - Street 2:SUITE B
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-1604
Practice Address - Country:US
Practice Address - Phone:630-279-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042617232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
EINOtherFEDERAL EIN