John Mark Schrock, LMT
Individual provider Active NPI Specialist · Arthur, IL
NPI 1972045508 · NPPES record last updated Nov 14, 2016
Key facts
- NPI
- 1972045508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 227018147 (IL)
- Practice address
- 1723B State Highway 133
Arthur, IL 61911-6110 - Phone
- (941) 724-0985
- NPI assigned
- Nov 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227018147 | IL | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 227018147 | IL | Yes |
Addresses
Primary practice location
1723B State Highway 133
Arthur, IL 61911-6110
Mailing address
1723B State Highway 133
Arthur, IL 61911-6110
Phone (941) 724-0985
Other providers in Arthur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.