Provider Demographics
NPI:1083694137
Name:SCHILLER, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:SCHILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1425 N UNION BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2871
Mailing Address - Country:US
Mailing Address - Phone:719-570-7675
Mailing Address - Fax:719-471-9314
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6831
Practice Address - Country:US
Practice Address - Phone:719-776-5281
Practice Address - Fax:719-471-9314
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO179032085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01179035Medicaid
CO840762242001OtherRMHMO
CO1600368OtherRRW MEDICARE
CO84076224204OtherPACIFICARE
COC80914Medicare ID - Type Unspecified
CO84076224204OtherPACIFICARE