Basic Information
Provider Information
NPI: 1083789820
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHULZ
FirstName: RITA
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 - 15TH AVE
Address2: STE 180
City: SOUTH MILWAUKEE
State: WI
PostalCode: 531721160
CountryCode: US
TelephoneNumber: 4147685430
FaxNumber: 4147624225
Practice Location
Address1: 4448 W. LOOMIS RD.
Address2: STE 100
City: GREENFIELD
State: WI
PostalCode: 532204851
CountryCode: US
TelephoneNumber: 4142815150
FaxNumber: 4142815767
Other Information
ProviderEnumerationDate: 11/21/2006
LastUpdateDate: 11/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X33769-20WIY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home