Provider Demographics
NPI:1235452889
Name:SCHILKE, TAD (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAD
Middle Name:
Last Name:SCHILKE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 OFFICE PARK RD STE 216
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2509
Mailing Address - Country:US
Mailing Address - Phone:800-705-2930
Mailing Address - Fax:
Practice Address - Street 1:1001 OFFICE PARK RD STE 216
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2509
Practice Address - Country:US
Practice Address - Phone:800-705-2930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15224-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist