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General NPI Number Information
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NPI Number | 1245384684
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Entity Type | Individual
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Provider Name | ELLEN R. SCHWARTZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 401 KELBURN ROAD
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City | DEERFIELD
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State | IL
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Zip | 60015-4361
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Country | US
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Telephone | 847-274-1494
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Fax | 847-505-0801
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Provider Business Mailing Address
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Address Line | PO BOX 185
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City | DEERFIELD
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State | IL
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Zip | 60015-0185
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 336051302
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License Number State | IL
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