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NPI Code Detail

MEDICARE: DR. LAURA T SCHULTZ PSY.D.

MEDICARE: DR. LAURA T SCHULTZ 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
1103TC0700XClinical Psychologist071-004309IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1IL5230OTHERILPART B

General Provider Information

NPI Number : 1548263379
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA T SCHULTZ PSY.D.
Provider Business Mailing Address
First Line : 13 FAIRLANE DR
Second Line :
City : JOLIET
State : IL
Zip : 60435-6483
Country : US
Telephone Number : 312-802-1956
Fax Number :
Provider Business Practice Location Address
First Line : 13 FAIRLANE DR
Second Line :
City : JOLIET
State : IL
Zip : 60435-6483
Country : US
Telephone Number : 312-802-1956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 05/12/2015

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