Provider Demographics
NPI:1790833192
Name:SCHNEIDER, THOMAS F JR (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:SCHNEIDER
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 W IRVING PARK RD STE D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2641
Mailing Address - Country:US
Mailing Address - Phone:773-794-1332
Mailing Address - Fax:773-794-1032
Practice Address - Street 1:4949 W IRVING PARK RD STE D
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2641
Practice Address - Country:US
Practice Address - Phone:773-794-1332
Practice Address - Fax:773-794-1032
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics