Provider Demographics
NPI:1043642085
Name:SCHULTZ, PATRICIA ANN (DO)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 WAUKEGAN ROAD
Mailing Address - Street 2:ROBERT MORRIS UNIVERSITY
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085
Mailing Address - Country:US
Mailing Address - Phone:847-578-6000
Mailing Address - Fax:
Practice Address - Street 1:1507 WAUKEGAN ROAD
Practice Address - Street 2:ROBERT MORRIS UNIVERSITY
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-6727
Practice Address - Country:US
Practice Address - Phone:847-578-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-093250207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine