Provider Demographics
NPI:1992734511
Name:SCHEETZ, PAUL HAROLD (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HAROLD
Last Name:SCHEETZ
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 1:13975 HUSEMAN ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-9055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25646 S GOVERNORS HWY UNIT A
Practice Address - Street 2:
Practice Address - City:MONEE
Practice Address - State:IL
Practice Address - Zip Code:60449-8921
Practice Address - Country:US
Practice Address - Phone:708-534-5248
Practice Address - Fax:708-534-5519
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932106OtherBC PROVIDER NUMBER
IL9932106OtherBC PROVIDER NUMBER
IL204661Medicare ID - Type Unspecified