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General NPI Number Information
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NPI Number | 1245857101
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Entity Type | Individual
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Provider Name | KYLE VAN SCHWICKERATH DPM
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Gender | Male
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 26900 N LAKE PLEASANT PKWY STE 202
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City | PEORIA
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State | AZ
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Zip | 85383-1558
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Country | US
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Telephone | 623-254-7111
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Fax | 623-254-7100
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Provider Business Mailing Address
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Address Line | 26900 N LAKE PLEASANT PKWY STE 202
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City | PEORIA
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State | AZ
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Zip | 85383-1558
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Country | US
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Telephone | 623-254-7111
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Fax | 623-254-7100
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD-001091
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License Number State | AZ
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