1851397822 NPI number — DR. AMY L SCHOCHLER DO

Table of content: DR. AMY L SCHOCHLER DO (NPI 1851397822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851397822 NPI number — DR. AMY L SCHOCHLER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHOCHLER
Provider First Name:
AMY
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851397822
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 776084
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60677-6084
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-364-4200
Provider Business Mailing Address Fax Number:
314-364-6321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7003 CHAD COLLEY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARLING
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72923-3000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-314-7490
Provider Business Practice Location Address Fax Number:
479-452-2098
Provider Enumeration Date:
06/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  E8134 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: N6987 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 0-285 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 216067301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200497470A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 806369700 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200447003 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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