MEDICARE: DAVID J SCHUMER DDS PC

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	261QD0000X	Dental Clinic/Center	019019279	IL

General Provider Information

NPI Number	:	1639248636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID J SCHUMER DDS PC

Provider Business Mailing Address
First Line	:	901 BIESTERFIELD RD
Second Line	:	SUITE 111
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3392
Country	:	US
Telephone Number	:	847-439-1371
Fax Number	:	847-439-1373

Provider Business Practice Location Address
First Line	:	756 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3545
Country	:	US
Telephone Number	:	847-439-1371
Fax Number	:	847-439-1372

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID JAY SCHUMER
Credential	:	DDS
Telephone Number	:	847-439-1371

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	05/28/2015

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