MEDICARE: DR. SAMANTHA ROBIN SCHULZE PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	071.006254	IL

General Provider Information

NPI Number	:	1023263308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMANTHA ROBIN SCHULZE PSY.D.

Provider Business Mailing Address
First Line	:	656 HYACINTH PL
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-1170
Country	:	US
Telephone Number	:	847-780-4104
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 N WILKE RD
Second Line	:	SUITE 160
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1278
Country	:	US
Telephone Number	:	847-577-0881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2008
Last Update Date	:	11/30/2008

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