Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G83205 | CA |
N | 208600000X | Surgeon | G83205 | CA |
Y | 2086S0102X | Surgical Critical Care | 036115938 | IL |
N | 2086S0102X | Surgical Critical Care | 1574 | WI |
N | 2086S0102X | Surgical Critical Care | G83205 | CA |
NPI | 1114952520 |
---|---|
Provider Name | Carol R Schermer |
First Address | Sacramento, CA 95817-2201 |
Second Address | Chicago, IL 60612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 18/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036115938 | (05) | IL |
G44521 | (02) |