Provider Demographics
NPI:1811969181
Name:SCHROEDER, JULIE MARIE (MD)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:SCHROEDER
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 1:2740 HAPPY JOE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3220
Mailing Address - Country:US
Mailing Address - Phone:563-526-4536
Mailing Address - Fax:508-928-4165
Practice Address - Street 1:2740 HAPPY JOE DR STE 1
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3220
Practice Address - Country:US
Practice Address - Phone:563-526-4536
Practice Address - Fax:508-928-4165
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103037207Q00000X
IA33124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA33124OtherLIC
IL8122900OtherBCBS GROUP NUMBER
IL036-092392Medicaid
076646OtherHEALTH ALLIANCE
IL036103037OtherLIC
080191446OtherMEDICARE RAILROAD
IA1186965Medicaid
IA17594OtherBLUE CROSS BLUE SHIELD
IL036103037OtherLIC
G96739Medicare UPIN
IA1186965Medicaid