Provider Demographics
NPI:1689762502
Name:SCHWARTZ, JOEL (DO)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25070 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1250
Mailing Address - Country:US
Mailing Address - Phone:847-585-7000
Mailing Address - Fax:847-240-0622
Practice Address - Street 1:8915 W GOLF RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-5905
Practice Address - Country:US
Practice Address - Phone:847-827-9060
Practice Address - Fax:847-827-7196
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361118092085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111809Medicaid
K11678Medicare ID - Type Unspecified
IL036111809Medicaid
IL355030004Medicare PIN
ILP00967883Medicare PIN