Provider Demographics
NPI:1942630256
Name:SCHULZE, JEANINE (MS, CGC)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:
Last Name:SCHULZE
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5440
Mailing Address - Country:US
Mailing Address - Phone:312-227-6943
Mailing Address - Fax:312-227-9413
Practice Address - Street 1:225 E CHICAGO AVE # 59
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-6943
Practice Address - Fax:312-227-9413
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2460000137170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS