Provider Demographics
NPI:1285886762
Name:SCHWAN, JEFFREY RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:RYAN
Last Name:SCHWAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 DUNDEE RD
Mailing Address - Street 2:SUITE 2C4
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2324
Mailing Address - Country:US
Mailing Address - Phone:224-235-4651
Mailing Address - Fax:224-235-4654
Practice Address - Street 1:3340 DUNDEE RD
Practice Address - Street 2:SUITE 2C4
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2324
Practice Address - Country:US
Practice Address - Phone:224-235-4651
Practice Address - Fax:224-235-4654
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011182111N00000X
WACH 60062374111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor