MEDICARE: DR. JEREMY SCHWARTZ DPM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP1100X	Podiatric Clinic/Center	016.005545	IL

General Provider Information

NPI Number	:	1073921193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. JEREMY SCHWARTZ DPM LLC

Provider Business Mailing Address
First Line	:	3118 N SHEFFIELD AVE
Second Line	:	#1S
City	:	CHICAGO
State	:	IL
Zip	:	60657-8680
Country	:	US
Telephone Number	:	847-370-8362
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 W HAWTHORNE PL
Second Line	:	#3003
City	:	CHICAGO
State	:	IL
Zip	:	60657-2907
Country	:	US
Telephone Number	:	847-370-8362
Fax Number	:

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. JEREMY SCHWARTZ
Credential	:
Telephone Number	:	847-370-8362

Provider Enumeration Date	:	08/01/2014
Last Update Date	:	08/01/2014

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