Provider Demographics
NPI:1255458394
Name:SCHOLTZ, CAROLINE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:SCHOLTZ
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 MILWAUKEE AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-3010
Mailing Address - Country:US
Mailing Address - Phone:847-478-8100
Mailing Address - Fax:847-478-8812
Practice Address - Street 1:185 MILWAUKEE AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3010
Practice Address - Country:US
Practice Address - Phone:847-478-8100
Practice Address - Fax:847-478-8812
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0210013231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL021001323OtherSP PEDIATRIC DENTISTRY
IL319008708OtherCONTOLLED SUBSTANCE IL
IL019019265OtherDENTAL LICENSE