1558768598 NPI number — DR. CRYSTAL ELIZABETH EDLER SCHILLER PH.D.

Table of content: DR. CRYSTAL ELIZABETH EDLER SCHILLER PH.D. (NPI 1558768598)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558768598 NPI number — DR. CRYSTAL ELIZABETH EDLER SCHILLER PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHILLER
Provider First Name:
CRYSTAL
Provider Middle Name:
ELIZABETH EDLER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EDLER
Provider Other First Name:
CRYSTAL
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558768598
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
234 MEDICAL SCHOOL WING C
Provider Second Line Business Mailing Address:
CAMPUS BOX 7160
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27599-7160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-966-4810
Provider Business Mailing Address Fax Number:
919-966-5628

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
234 MEDICAL SCHOOL WING C
Provider Second Line Business Practice Location Address:
CAMPUS BOX 7160
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27599-7160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-4810
Provider Business Practice Location Address Fax Number:
919-966-5628
Provider Enumeration Date:
11/19/2014

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: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 4733 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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