Provider Demographics
NPI:1649265133
Name:SCHERER, MICHAEL A (DPM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:SCHERER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 N SEMINARY STREET
Mailing Address - Street 2:STE 406
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401
Mailing Address - Country:US
Mailing Address - Phone:309-341-1300
Mailing Address - Fax:309-341-1377
Practice Address - Street 1:834 N SEMINARY STREET
Practice Address - Street 2:STE 406
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401
Practice Address - Country:US
Practice Address - Phone:309-341-1300
Practice Address - Fax:309-341-1377
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004267213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016004267Medicaid
IL5725610001Medicare NSC
IL1649265133Medicare PIN
IL016004267Medicaid
202728Medicare ID - Type Unspecified