Provider Demographics
NPI:1740334457
Name:SCHULTZ, MARGARET ANN (LPN)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16451 RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1880
Mailing Address - Country:US
Mailing Address - Phone:708-532-1462
Mailing Address - Fax:
Practice Address - Street 1:16451 RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1880
Practice Address - Country:US
Practice Address - Phone:708-532-1462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL43024338164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse