MEDICARE: LAWRENCE J SCHOUTEN MD

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	207R00000X	Internal Medicine Physician	036066066	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F400172434	OTHER	IL	MEDICARE PTAN (INDIVIDUAL)
2	920540	OTHER	IL	MEDICARE PTAN (GROUP)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699770164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE J SCHOUTEN MD

Provider Business Mailing Address
First Line	:	501 THORNHILL DR
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-2793
Country	:	US
Telephone Number	:	630-668-3210
Fax Number	:	630-668-3505

Provider Business Practice Location Address
First Line	:	501 THORNHILL DR # DDR
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188
Country	:	US
Telephone Number	:	630-668-3210
Fax Number	:	630-668-3505

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	09/19/2018

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Directions to “ LAWRENCE J SCHOUTEN MD” Practice Location

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