Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 038006976 | IL |
NPI | 1134101777 |
---|---|
Provider Name | Dr. Gordon T. Scherzer |
First Address | Fox River Grove, IL 60021-0051 |
Second Address | Trout Valley, IL 60013-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 26/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U35072 | (02) | IL |