Provider Demographics
NPI:1003000845
Name:JAMES D.SCHLENKER MDSC
Entity type:Organization
Organization Name:JAMES D.SCHLENKER MDSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHLENKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-423-2258
Mailing Address - Street 1:6311 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2201
Mailing Address - Country:US
Mailing Address - Phone:708-423-2258
Mailing Address - Fax:708-423-2305
Practice Address - Street 1:6311 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2201
Practice Address - Country:US
Practice Address - Phone:708-423-2258
Practice Address - Fax:708-423-2305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCL1274OtherRR MEDICARE
IL659401Medicare PIN
IL1010380001Medicare NSC
ILL27714Medicare PIN
ILC45204Medicare UPIN