MEDICARE: DR. JAMES CHARLES SCHARDT D.D.S.

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	1223G0001X	General Practice Dentistry	19014149	IL

General Provider Information

NPI Number	:	1518064914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES CHARLES SCHARDT D.D.S.

Provider Business Mailing Address
First Line	:	1824 WILMETTE AVE
Second Line	:	1320 MAPLE AVE.
City	:	WILMETTE
State	:	IL
Zip	:	60091-2429
Country	:	US
Telephone Number	:	847-251-0052
Fax Number	:	847-251-1183

Provider Business Practice Location Address
First Line	:	1824 WILMETTE AVE
Second Line	:	1320 MAPLE AVE.
City	:	WILMETTE
State	:	IL
Zip	:	60091-2429
Country	:	US
Telephone Number	:	847-251-0052
Fax Number	:	847-251-1183

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/06/2023

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