Healthcare Provider Details
I. General information
NPI: 1679503171
Provider Name (Legal Business Name): JENNIFER SHERMAN SCHOTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/03/2006
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 LAKE COOK RD STE 119
DEERFIELD IL
60015
US
IV. Provider business mailing address
49 S WAUKEGAN RD STE 100
DEERFIELD IL
60015-5204
US
V. Phone/Fax
- Phone: 847-945-3850
- Fax:
- Phone: 847-945-3850
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036104266 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: