1992734511 NPI number — DR. PAUL HAROLD SCHEETZ D.C.

Table of content: DR. PAUL HAROLD SCHEETZ D.C. (NPI 1992734511)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992734511 NPI number — DR. PAUL HAROLD SCHEETZ D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHEETZ
Provider First Name:
PAUL
Provider Middle Name:
HAROLD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992734511
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13975 HUSEMAN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDAR LAKE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46303-9055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25646 S GOVERNORS HWY UNIT A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONEE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60449-8921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-534-5248
Provider Business Practice Location Address Fax Number:
708-534-5519
Provider Enumeration Date:
07/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  038009781 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9932106 . This is a "BC PROVIDER NUMBER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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