Provider Demographics
NPI:1851611743
Name:SCHWARZ, JACQUELINE FAY (DO)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:FAY
Last Name:SCHWARZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 N. ARLINGTON HEIGHTS RD.
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004
Mailing Address - Country:US
Mailing Address - Phone:847-398-0400
Mailing Address - Fax:847-398-9590
Practice Address - Street 1:3325 N. ARLINGTON HEIGHTS RD.
Practice Address - Street 2:SUITE 100A
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004
Practice Address - Country:US
Practice Address - Phone:847-398-0400
Practice Address - Fax:847-398-9590
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.058107208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics