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General NPI Number Information
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NPI Number | 1144803396
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Entity Type | Individual
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Provider Name | SCOTT AUSTIN SCHLAGEL
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Gender | Male
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 2511 N KEDZIE BLVD
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City | CHICAGO
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State | IL
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Zip | 60647-2603
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Country | US
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Telephone | 773-292-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 1096 SEVILLE RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3025
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Country | US
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Telephone | 248-917-2134
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10003574A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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