Provider Demographics
NPI:1972664902
Name:SCHREDER, TONYA (MD)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:SCHREDER
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 1:2 TRANSAM PLAZA DR STE 410
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4290
Mailing Address - Country:US
Mailing Address - Phone:866-259-1631
Mailing Address - Fax:855-618-2629
Practice Address - Street 1:2 TRANSAM PLAZA DR STE 410
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181
Practice Address - Country:US
Practice Address - Phone:866-259-1631
Practice Address - Fax:855-618-2629
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36101698207RG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
R00861OtherPTAN
R00861OtherPTAN
H36369Medicare UPIN