Healthcare Provider Details

I. General information

NPI: 1598403917
Provider Name (Legal Business Name): YITZCHAK SCHULTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ISAAC SCHULTZ MD

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 DEMPSTER ST
PARK RIDGE IL
60068-1174
US

IV. Provider business mailing address

1775 DEMPSTER ST
PARK RIDGE IL
60068-1174
US

V. Phone/Fax

Practice location:
  • Phone: 847-723-2210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125.080255
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: