Provider Demographics
NPI:1740216001
Name:KALWEIT SCHMELING, JULIETTE A (MD)
Entity Type:Individual
Prefix:MRS
First Name:JULIETTE
Middle Name:A
Last Name:KALWEIT SCHMELING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIETTE
Other - Middle Name:ANNE
Other - Last Name:KALWEIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1658 S IL ROUTE 2
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:IL
Mailing Address - Zip Code:61061-9514
Mailing Address - Country:US
Mailing Address - Phone:815-732-2499
Mailing Address - Fax:815-732-6077
Practice Address - Street 1:1658 S IL ROUTE 2
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:IL
Practice Address - Zip Code:61061-9514
Practice Address - Country:US
Practice Address - Phone:815-732-2499
Practice Address - Fax:815-732-6077
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083457207Q00000X
IL036-083457207RH0002X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036083457Medicaid
IL846930Medicare ID - Type UnspecifiedMEDICARE GROUP #
IL036083457Medicaid
ILF13507Medicare UPIN
IL080115344Medicare ID - Type UnspecifiedRR INDIVIDUAL #
ILCC5050Medicare ID - Type UnspecifiedRR MEDICARE GROUP #