Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036083457 | IL |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 036-083457 | IL |
N | 207RH0002X | Hospice and Palliative Medicine | 036-083457 | IL |
NPI | 1740216001 |
---|---|
Provider Name | Mrs. Juliette A Kalweit Schmeling |
First Address | Oregon, IL 61061-9514 |
Second Address | Oregon, IL 61061-9514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 19/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036083457 | (05) | IL |
F13507 | (02) | IL |