Provider Demographics
NPI:1760003834
Name:SCHOENBECK, NICHOLAS
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:SCHOENBECK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7288 W PALATINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1944
Mailing Address - Country:US
Mailing Address - Phone:773-633-0533
Mailing Address - Fax:
Practice Address - Street 1:901 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3230
Practice Address - Country:US
Practice Address - Phone:847-384-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051302646183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist