Provider Demographics
NPI:1073075420
Name:SCHROH, DEBORAH KAY
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:SCHROH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 RAVINE WAY STE 400
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-7621
Mailing Address - Country:US
Mailing Address - Phone:847-832-6700
Mailing Address - Fax:847-832-9430
Practice Address - Street 1:2350 RAVINE WAY STE 400
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-7621
Practice Address - Country:US
Practice Address - Phone:847-832-6700
Practice Address - Fax:847-832-9430
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL188187246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist