Provider Demographics
NPI:1043210594
Name:SCHINKE, THERESA LYNN (DPM)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:LYNN
Last Name:SCHINKE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 E NORTHLAND AVE
Mailing Address - Street 2:STE B
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-8426
Mailing Address - Country:US
Mailing Address - Phone:920-731-1999
Mailing Address - Fax:920-731-3729
Practice Address - Street 1:1301 E NORTHLAND AVE
Practice Address - Street 2:STE B
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-8426
Practice Address - Country:US
Practice Address - Phone:920-731-1999
Practice Address - Fax:920-731-3729
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI902-025213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43239600Medicaid
WIBS9222718OtherDEA
WI86570Medicare PIN
WIV05256Medicare UPIN
WI0746740001Medicare NSC