Provider Demographics
NPI:1538214960
Name:SCHURGER, FREDERICK THEODORE (DC)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:THEODORE
Last Name:SCHURGER
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 1:450 S DURKIN DR STE B
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-7211
Mailing Address - Country:US
Mailing Address - Phone:217-698-7900
Mailing Address - Fax:217-698-7920
Practice Address - Street 1:450 S DURKIN DR STE B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-7211
Practice Address - Country:US
Practice Address - Phone:248-259-6591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38010862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
8432173OtherBCBS
8432173OtherBCBS