Healthcare Provider Details

I. General information

NPI: 1568301141
Provider Name (Legal Business Name): CHUL SCHWANKE MSW, LGSW, LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W 49TH ST
MINNEAPOLIS MN
55419-5526
US

IV. Provider business mailing address

1 W 49TH ST
MINNEAPOLIS MN
55419-5526
US

V. Phone/Fax

Practice location:
  • Phone: 612-668-4040
  • Fax: 612-668-4030
Mailing address:
  • Phone: 612-668-4040
  • Fax: 612-668-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number14131
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: