Provider Demographics
NPI:1235233628
Name:SCHLUND, MARIE CATHERINE (DPM)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:CATHERINE
Last Name:SCHLUND
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-1730
Mailing Address - Country:US
Mailing Address - Phone:630-773-2478
Mailing Address - Fax:630-773-3695
Practice Address - Street 1:209 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:ITASCA
Practice Address - State:IL
Practice Address - Zip Code:60143-1730
Practice Address - Country:US
Practice Address - Phone:630-773-2478
Practice Address - Fax:630-773-3695
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016 004114213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5673360001Medicare NSC
ILT39154Medicare UPIN
ILK27569Medicare PIN