Healthcare Provider Details

I. General information

NPI: 1194706374
Provider Name (Legal Business Name): KEITH E SCHROEDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 W SCHICK RD
BARTLETT IL
60103-3007
US

IV. Provider business mailing address

9 BACK BAY DR
SOUTH BARRINGTON IL
60010-9503
US

V. Phone/Fax

Practice location:
  • Phone: 847-989-1399
  • Fax:
Mailing address:
  • Phone: 847-254-7868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036-045779
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: