Provider Demographics
NPI:1851383418
Name:OLIGSCHLAEGER, DAVID M (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:OLIGSCHLAEGER
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 1:207 S PINE ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62565-1749
Mailing Address - Country:US
Mailing Address - Phone:217-774-7883
Mailing Address - Fax:
Practice Address - Street 1:200 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62565-1838
Practice Address - Country:US
Practice Address - Phone:217-774-4400
Practice Address - Fax:217-774-6445
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099152207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036099152Medicaid
IL371444997OtherTIN
ILK32830Medicare PIN
IL036099152Medicaid
IL371444997OtherTIN