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General NPI Number Information
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NPI Number | 1386892172
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Entity Type | Individual
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Provider Name | MARY L SCHINKEL D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 11/26/2021
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Provider Practice Location Address
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Address Line | 4 MEMORIAL DR STE 230B
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City | ALTON
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State | IL
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Zip | 62002-6751
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Country | US
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Telephone | 314-653-6093
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Fax | 314-653-6094
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Provider Business Mailing Address
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Address Line | 4 MEMORIAL DR STE 230B
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City | ALTON
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State | IL
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Zip | 62002-6751
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Country | US
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Telephone | 314-653-6093
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Fax | 314-653-6094
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 2008007457
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 54586
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 2008007457
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 036136023
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License Number State | IL
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