Healthcare Provider Details

I. General information

NPI: 1255568663
Provider Name (Legal Business Name): ERIN SCHULZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 MCDONOUGH ST
JOLIET IL
60436-1841
US

IV. Provider business mailing address

2209 MCDONOUGH ST
JOLIET IL
60436-1841
US

V. Phone/Fax

Practice location:
  • Phone: 815-725-1102
  • Fax: 815-725-7500
Mailing address:
  • Phone: 815-725-1102
  • Fax: 815-725-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number049175865
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: