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General NPI Number Information
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NPI Number | 1487512356
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Entity Type | Individual
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Provider Name | DR. JACQUELINE SCHABOLD
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Gender | Female
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 17729 NASSAU DR
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City | BROOKFIELD
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State | WI
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Zip | 53045-3436
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Country | US
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Telephone | 773-759-6225
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Fax |
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Provider Business Mailing Address
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Address Line | 17729 NASSAU DR
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City | BROOKFIELD
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State | WI
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Zip | 53045-3436
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Country | US
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Telephone | 773-759-6225
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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 | 1835C0207X
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Taxonomy Name | Compounded Sterile Preparations Pharmacist
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License Number | 18138-40
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License Number State | WI
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