Provider Demographics
NPI:1306996608
Name:SCHUSTER, LISELOTTE (DC)
Entity type:Individual
Prefix:DR
First Name:LISELOTTE
Middle Name:
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 CHICAGO AVE
Mailing Address - Street 2:UNIT 102
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-6006
Mailing Address - Country:US
Mailing Address - Phone:847-866-9557
Mailing Address - Fax:
Practice Address - Street 1:1535 LAKE COOK RD
Practice Address - Street 2:SUITE 204
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1447
Practice Address - Country:US
Practice Address - Phone:847-509-9067
Practice Address - Fax:847-509-9069
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL912470Medicare ID - Type UnspecifiedPROVIDER NUMBER