Provider Demographics
NPI:1639375074
Name:ZECHOWY, JILL SCHMIDTLEIN (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:SCHMIDTLEIN
Last Name:ZECHOWY
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4106
Mailing Address - Country:US
Mailing Address - Phone:707-515-6673
Mailing Address - Fax:
Practice Address - Street 1:725 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4106
Practice Address - Country:US
Practice Address - Phone:707-515-6673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG91514Medicare UPIN