Provider Demographics
NPI:1881724953
Name:SCHILL, THOMAS MARK (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MARK
Last Name:SCHILL
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:PO BOX 1550
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-1550
Mailing Address - Country:US
Mailing Address - Phone:541-678-0010
Mailing Address - Fax:541-323-6131
Practice Address - Street 1:371 SW UPPER TERRACE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1560
Practice Address - Country:US
Practice Address - Phone:541-678-0010
Practice Address - Fax:541-323-6131
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500668352Medicaid
ORR173744Medicare PIN