MEDICARE: JAMES J SCHROEDER, DDS LTD

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	122300000X	Dentist		IL

General Provider Information

NPI Number	:	1932252392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES J SCHROEDER, DDS LTD

Provider Business Mailing Address
First Line	:	7424 HANCOCK DR
Second Line	:
City	:	WONDER LAKE
State	:	IL
Zip	:	60097-9217
Country	:	US
Telephone Number	:	815-653-5141
Fax Number	:

Provider Business Practice Location Address
First Line	:	7424 HANCOCK DR
Second Line	:
City	:	WONDER LAKE
State	:	IL
Zip	:	60097-9217
Country	:	US
Telephone Number	:	815-653-5141
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES J SCHROEDER
Credential	:	DDS
Telephone Number	:	815-653-5141

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	08/22/2020

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