Provider Demographics
NPI:1184844540
Name:SCHROETTER DENTAL ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:SCHROETTER DENTAL ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROETTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-372-7752
Mailing Address - Street 1:25 E WASHINGTON ST
Mailing Address - Street 2:SUITE 1901
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1708
Mailing Address - Country:US
Mailing Address - Phone:312-372-7752
Mailing Address - Fax:312-372-1152
Practice Address - Street 1:25 E WASHINGTON ST
Practice Address - Street 2:SUITE 1901
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1708
Practice Address - Country:US
Practice Address - Phone:312-372-7752
Practice Address - Fax:312-372-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty