Provider Demographics
NPI:1831221977
Name:SCHLUNTZ, MICHELE (MS, ATC LAT EMT-P)
Entity type:Individual
Prefix:MISS
First Name:MICHELE
Middle Name:
Last Name:SCHLUNTZ
Suffix:
Gender:F
Credentials:MS, ATC LAT EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 ASHLAND CIR
Mailing Address - Street 2:APARTMENT 4
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-3354
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2401 ASHLAND CIR
Practice Address - Street 2:APARTMENT 4
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-3354
Practice Address - Country:US
Practice Address - Phone:815-577-5727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer