Provider Demographics
NPI:1083753172
Name:SCHILLER, STANLEY J (OD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:J
Last Name:SCHILLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3-3100 KUHIO HWY STE C15
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1153
Mailing Address - Country:US
Mailing Address - Phone:808-246-8855
Mailing Address - Fax:808-246-0415
Practice Address - Street 1:3-3100 KUHIO HWY STE C15
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1153
Practice Address - Country:US
Practice Address - Phone:808-246-8855
Practice Address - Fax:808-246-0415
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI0239152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHI0239OtherEYEMED
HI02370401Medicaid
HI02635-1OtherHMSA
HI0000026351OtherHMSA QUEST