MEDICARE: DR. EDWARD ARTHUR SCHULZ DPM

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	213E00000X	Podiatrist		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04901069	OTHER		BLUE CROSS

General Provider Information

NPI Number	:	1093702243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD ARTHUR SCHULZ DPM

Provider Business Mailing Address
First Line	:	1170 E BELVIDERE RD
Second Line	:	STE 203
City	:	GRAYSLAKE
State	:	IL
Zip	:	60030-2061
Country	:	US
Telephone Number	:	847-543-4300
Fax Number	:	847-543-4044

Provider Business Practice Location Address
First Line	:	550 N MIDLOTHIAN RD
Second Line	:	STE 100
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-1613
Country	:	US
Telephone Number	:	847-566-9030
Fax Number	:	847-566-9034

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

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	04/18/2008

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