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General NPI Number Information
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NPI Number | 1538730072
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Entity Type | Individual
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Provider Name | STEPHANIE SCHREIBER DMD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 632 S MAIN ST
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City | CREVE COEUR
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State | IL
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Zip | 61610-3974
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Country | US
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Telephone | 309-340-1624
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Fax |
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Provider Business Mailing Address
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Address Line | 141 W JACKSON BLVD STE 210
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City | CHICAGO
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State | IL
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Zip | 60604-3048
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.033225
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License Number State | IL
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