=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811969181
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE MARIE SCHROEDER MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2006
-----------------------------------------------------
Last Update Date | 03/23/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2740 HAPPY JOE DR STE 1
-----------------------------------------------------
City | BETTENDORF
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52722-3220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 563-526-4536
-----------------------------------------------------
Fax | 508-928-4165
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2740 HAPPY JOE DR STE 1
-----------------------------------------------------
City | BETTENDORF
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52722-3220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 563-526-4536
-----------------------------------------------------
Fax | 508-928-4165
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 036103037
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 33124
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------