Provider Demographics
NPI:1679682371
Name:SCHRAM, GALIN DEAN (DC)
Entity type:Individual
Prefix:DR
First Name:GALIN
Middle Name:DEAN
Last Name:SCHRAM
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 1:1009 LORAS DR
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-6923
Mailing Address - Country:US
Mailing Address - Phone:815-233-1800
Mailing Address - Fax:815-235-7749
Practice Address - Street 1:1009 LORAS DR
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-6923
Practice Address - Country:US
Practice Address - Phone:815-233-1800
Practice Address - Fax:815-235-7749
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038004173111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038004173Medicaid
IL350028521OtherPALMETTO GBA RAILROAD MEDICARE
IL10121871OtherBLUE CROSS BLUE SHIELD OF ILLINOIS
IL350028521OtherPALMETTO GBA RAILROAD MEDICARE
T37508Medicare UPIN