Healthcare Provider Details

I. General information

NPI: 1164436275
Provider Name (Legal Business Name): DIANE H SCHAAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 E 93RD ST ROOM 200
CHICAGO IL
60617-3936
US

IV. Provider business mailing address

33 GRAYMOOR LN
OLYMPIA FIELDS IL
60461-1209
US

V. Phone/Fax

Practice location:
  • Phone: 773-734-3970
  • Fax: 773-734-6832
Mailing address:
  • Phone: 708-748-3969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036059627
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: