Healthcare Provider Details

I. General information

NPI: 1538168695
Provider Name (Legal Business Name): LEE SCOTT SCHWARTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E HURON ST SUITE 1101
CHICAGO IL
60611-2999
US

IV. Provider business mailing address

150 E HURON ST SUITE 1101
CHICAGO IL
60611-2999
US

V. Phone/Fax

Practice location:
  • Phone: 847-256-0576
  • Fax: 312-642-2934
Mailing address:
  • Phone: 847-256-0576
  • Fax: 312-642-2934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036060732
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: