Provider Demographics
NPI:1942512538
Name:SCHRIEBER, JESSICA M (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:SCHRIEBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N19W23993 RIDGEVIEW PKWY W STE 100
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1031
Mailing Address - Country:US
Mailing Address - Phone:262-547-3352
Mailing Address - Fax:262-547-9142
Practice Address - Street 1:N19W23993 RIDGEVIEW PKWY W STE 100
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1031
Practice Address - Country:US
Practice Address - Phone:262-547-3352
Practice Address - Fax:262-547-9142
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35123462207W00000X
KY47316207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000872504OtherBCBS
IN201229810Medicaid
OH0103912Medicaid
KYK138070Medicare PIN
OH000000872504OtherBCBS