Healthcare Provider Details

I. General information

NPI: 1962599514
Provider Name (Legal Business Name): MICHAEL LEE SCHMERMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6677 N LINCOLN AVE STE 300
LINCOLNWOOD IL
60712-3634
US

IV. Provider business mailing address

6677 N LINCOLN AVE STE 300
LINCOLNWOOD IL
60712-3634
US

V. Phone/Fax

Practice location:
  • Phone: 847-674-3014
  • Fax: 847-674-6190
Mailing address:
  • Phone: 847-674-3014
  • Fax: 847-674-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number021001006
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number019-015452
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: