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General NPI Number Information
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NPI Number | 1770854192
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Entity Type | Organization
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Legal Business Name | JAMES R SCHULTE DDS
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 01/17/2012
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Provider Practice Location Address
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Address Line | 12040 S HARLEM AVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1141
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Country | US
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Telephone | 708-448-5543
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Fax | 708-448-9596
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Provider Business Mailing Address
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Address Line | 12040 S HARLEM AVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1141
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Country | US
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Telephone | 708-448-5543
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Fax | 708-448-9596
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES R SCHULTE
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Credential | DDS
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Telephone | 708-448-5543
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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 | 0190157-17
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License Number State | IL
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