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General NPI Number Information
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NPI Number | 1851584395
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Entity Type | Organization
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Legal Business Name | MICHELLE H SCHULTZ MD PC
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 405 LAKE COOK RD DIPLOMAT PHARMACY
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City | DEERFIELD
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State | IL
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Zip | 60015-4993
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Country | US
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Telephone | 630-393-1201
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Fax |
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Provider Business Mailing Address
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Address Line | 915 BURNHAM CT
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City | AURORA
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State | IL
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Zip | 60502-9356
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Country | US
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Telephone | 630-393-1201
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELLE H SCHULTZ
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Credential | MD
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Telephone | 630-393-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 036-115932
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License Number State | IL
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