Provider Demographics
NPI:1902970387
Name:SZARMACH, MICHAEL D (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:SZARMACH
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 1:1395B MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-2961
Mailing Address - Country:US
Mailing Address - Phone:708-672-6744
Mailing Address - Fax:708-672-6788
Practice Address - Street 1:1395B MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-2961
Practice Address - Country:US
Practice Address - Phone:708-672-6744
Practice Address - Fax:708-672-6788
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007167111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09922996OtherBCBS PROVIDER NUMBER
IL038-007167OtherSTATE LICENSE NUMBER