Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036083186 | IL |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036-083186 | IL |
NPI | 1790873016 |
---|---|
Provider Name | David J Schleicher |
First Address | Milwaukee, WI 53278-8866 |
Second Address | Rockford, IL 61104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 19/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036083186 | (05) | IL |
E91486 | (02) | IL |