Provider Demographics
NPI:1629086210
Name:SCHWAB, THERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 W 95TH ST
Mailing Address - Street 2:EMERGENCY DEPARTMENT CHRIST HOSPITAL
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2600
Mailing Address - Country:US
Mailing Address - Phone:708-684-4077
Mailing Address - Fax:708-684-1028
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:EMERGENCY DEPARTMENT CHRIST HOSPITAL
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-4077
Practice Address - Fax:708-684-1028
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098161207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36098161Medicaid
ILK05273Medicare ID - Type Unspecified
ILG25196Medicare UPIN