Provider Demographics
NPI:1093759730
Name:SCHULZ, ESTHER (DO)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 955860
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-5860
Mailing Address - Country:US
Mailing Address - Phone:636-498-5944
Mailing Address - Fax:618-436-6254
Practice Address - Street 1:5 GOOD SAMARITAN WAY
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-2402
Practice Address - Country:US
Practice Address - Phone:618-899-1264
Practice Address - Fax:618-241-4848
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2021-09-27
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036082883207QB0002X, 207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09532006OtherBCBS
IL09532006OtherBCBS