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NPI Code Detail

MEDICARE: MS. MANDI N SCHULTZ PHARM TECH

MEDICARE:  MS. MANDI N SCHULTZ  PHARM TECH
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
1183700000XPharmacy TechnicianIL

General Provider Information

NPI Number : 1316029978
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MANDI N SCHULTZ PHARM TECH
Provider Business Mailing Address
First Line : 6031 W EDDY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-4212
Country : US
Telephone Number : 773-398-8465
Fax Number :
Provider Business Practice Location Address
First Line : 7124 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1904
Country : US
Telephone Number : 773-631-5333
Fax Number : 773-763-1402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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