Basic Information
| Provider Information | |||||||||
| NPI: | 1427493485 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHROEDER | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | J | ||||||||
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| NameSuffix: | II | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10001 W INNOVATION DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532264851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889383838 | ||||||||
| FaxNumber: | 8889191083 | ||||||||
| Practice Location | |||||||||
| Address1: | 984 WILLOW RD STE H | ||||||||
| Address2: | |||||||||
| City: | NORTHBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600626821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889383838 | ||||||||
| FaxNumber: | 8889191083 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2013 | ||||||||
| LastUpdateDate: | 10/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YS0123X | 65326 | MN | N | Allopathic & Osteopathic Physicians | Otolaryngology | Facial Plastic Surgery | 207Y00000X | 036161072 | IL | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.