Provider Demographics
NPI:1336435924
Name:SCHNEIDER, ALYSSA J (DC)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:J
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:IL
Mailing Address - Zip Code:62656-1524
Mailing Address - Country:US
Mailing Address - Phone:217-732-2140
Mailing Address - Fax:217-651-4924
Practice Address - Street 1:523 N ELM ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:IL
Practice Address - Zip Code:62656-1524
Practice Address - Country:US
Practice Address - Phone:217-732-2140
Practice Address - Fax:217-651-4924
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor