Provider Demographics
NPI:1093702243
Name:SCHULZ, EDWARD ARTHUR (DPM)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ARTHUR
Last Name:SCHULZ
Suffix:
Gender:M
Credentials:DPM
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Other - First Name:
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Mailing Address - Street 1:1170 E BELVIDERE RD
Mailing Address - Street 2:STE 203
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2061
Mailing Address - Country:US
Mailing Address - Phone:847-543-4300
Mailing Address - Fax:847-543-4044
Practice Address - Street 1:550 N MIDLOTHIAN RD
Practice Address - Street 2:STE 100
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1613
Practice Address - Country:US
Practice Address - Phone:847-566-9030
Practice Address - Fax:847-566-9034
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2008-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
04901069OtherBLUE CROSS
04901069OtherBLUE CROSS
4184110001Medicare NSC
T38813Medicare UPIN