Provider Demographics
NPI:1053368936
Name:SCHERER, MICHAEL RALPH (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RALPH
Last Name:SCHERER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10640 W 165TH STREET
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5653
Mailing Address - Country:US
Mailing Address - Phone:708-364-0261
Mailing Address - Fax:708-364-6019
Practice Address - Street 1:10640 W 165TH STREET
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5653
Practice Address - Country:US
Practice Address - Phone:708-364-0261
Practice Address - Fax:708-364-6019
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006893103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL071006893OtherSTATE LICENSE
ILK26756Medicare PIN
ILK22680Medicare PIN
IL215683Medicare PIN
IL215684Medicare PIN
IL206975Medicare PIN
IL071006893OtherSTATE LICENSE
IL211335Medicare PIN