MEDICARE: PROF. THOMAS J. SCHNITZER MD, PHD

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	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician		IL

General Provider Information

NPI Number	:	1588649461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. THOMAS J. SCHNITZER MD, PHD

Provider Business Mailing Address
First Line	:	710 N LAKE SHORE DR
Second Line	:	ROOM 1020
City	:	CHICAGO
State	:	IL
Zip	:	60611-3006
Country	:	US
Telephone Number	:	312-503-1500
Fax Number	:	312-503-1505

Provider Business Practice Location Address
First Line	:	345 E SUPERIOR ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2654
Country	:	US
Telephone Number	:	312-238-2784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	07/08/2007

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