Healthcare Provider Details

I. General information

NPI: 1467565069
Provider Name (Legal Business Name): LOUIS E SCHWING IV IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 W EVERGREEN AVE STE 202
EFFINGHAM IL
62401-1638
US

IV. Provider business mailing address

PO BOX 372
MATTOON IL
61938-0372
US

V. Phone/Fax

Practice location:
  • Phone: 217-238-4634
  • Fax: 217-342-3402
Mailing address:
  • Phone:
  • Fax: 217-258-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036102124
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number036-102124
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036102124
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: