Provider Demographics
NPI:1891987178
Name:SCHAAL, JASON STEVEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:STEVEN
Last Name:SCHAAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13267 MCDONALD RD
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:IL
Mailing Address - Zip Code:61914-9003
Mailing Address - Country:US
Mailing Address - Phone:217-665-3161
Mailing Address - Fax:217-665-3164
Practice Address - Street 1:3175 OLDE POST RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-3991
Practice Address - Country:US
Practice Address - Phone:217-412-6296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051040979183500000X
MO2009027317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist