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1861433138

NPI Code Detail

MEDICARE: DR. TIMOTHY SCHROER D.O.

MEDICARE: DR. TIMOTHY SCHROER D.O.

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	207P00000X	Emergency Medicine Physician	02003312A	IN
2	207P00000X	Emergency Medicine Physician	036-112038	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4622394	OTHER		BLUE CROSS

General Provider Information

NPI Number	:	1861433138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY SCHROER D.O.

Provider Business Mailing Address
First Line	:	555 W COURT ST
Second Line	:
City	:	KANKAKEE
State	:	IL
Zip	:	60901-3675
Country	:	US
Telephone Number	:	888-828-3192
Fax Number	:

Provider Business Practice Location Address
First Line	:	1423 CHICAGO RD
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-3400
Country	:	US
Telephone Number	:	708-756-1000
Fax Number	:

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	04/18/2024

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Directions to “ DR. TIMOTHY SCHROER D.O.” Practice Location

Language	Start Address	Practice Location

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