Healthcare Provider Details

I. General information

NPI: 1093014219
Provider Name (Legal Business Name): PHILLIP L SCHORFHEIDE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2011
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16808 ARBOR CREEK DR
PLAINFIELD IL
60586-5252
US

IV. Provider business mailing address

16808 ARBOR CREEK DR
PLAINFIELD IL
60586-5252
US

V. Phone/Fax

Practice location:
  • Phone: 773-391-3600
  • Fax:
Mailing address:
  • Phone: 773-391-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209008734
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: