MEDICARE: DR. BARBARA JO SCHRIVER DN

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	174400000X	Specialist	181000157	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01633278	OTHER	IL	BCBS
2	181000157	OTHER	IL	LICENSE

General Provider Information

NPI Number	:	1437234176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA JO SCHRIVER DN

Provider Business Mailing Address
First Line	:	6411 W 123RD ST
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1702
Country	:	US
Telephone Number	:	708-489-9918
Fax Number	:	798-925-0432

Provider Business Practice Location Address
First Line	:	6411 W 123RD ST
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1702
Country	:	US
Telephone Number	:	708-489-9918
Fax Number	:	798-925-0432

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/19/2008

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