Provider Demographics
NPI:1851350003
Name:SCHULZ, JENNIFER LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LOUISE
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S23W23187 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-8118
Mailing Address - Country:US
Mailing Address - Phone:563-650-5895
Mailing Address - Fax:
Practice Address - Street 1:1720 DOLPHIN DR STE E
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1489
Practice Address - Country:US
Practice Address - Phone:262-547-7441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06842111N00000X
WI5166-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA05891OtherBLUE CROSS BLUE SHIELD
IAI16746Medicare ID - Type Unspecified
IAV07880Medicare UPIN