Healthcare Provider Details

I. General information

NPI: 1447405592
Provider Name (Legal Business Name): MARY BETH SCHULIEN WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 S MICHIGAN AVE 6TH FL
CHICAGO IL
60603-3200
US

IV. Provider business mailing address

18 S MICHIGAN AVE 6TH FL
CHICAGO IL
60603-3200
US

V. Phone/Fax

Practice location:
  • Phone: 312-592-6800
  • Fax: 312-592-6801
Mailing address:
  • Phone: 312-592-6800
  • Fax: 312-592-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number209-001677
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: