Provider Demographics
NPI:1851584395
Name:MICHELLE H SCHULTZ MD PC
Entity Type:Organization
Organization Name:MICHELLE H SCHULTZ MD PC
Other - Org Name:CENTER FOR HEALTHY LIVING AND LONGEVITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-393-1201
Mailing Address - Street 1:915 BURNHAM CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9356
Mailing Address - Country:US
Mailing Address - Phone:630-393-1201
Mailing Address - Fax:
Practice Address - Street 1:405 LAKE COOK RD
Practice Address - Street 2:DIPLOMAT PHARMACY
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4993
Practice Address - Country:US
Practice Address - Phone:630-393-1201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-115932261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service