Provider Demographics
NPI:1104252576
Name:SCHLAGEL, THERESA (PHARM D)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:SCHLAGEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1174 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:MANTENO
Mailing Address - State:IL
Mailing Address - Zip Code:60950-5018
Mailing Address - Country:US
Mailing Address - Phone:815-932-9977
Mailing Address - Fax:708-755-1470
Practice Address - Street 1:990 N KINZIE AVE
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:IL
Practice Address - Zip Code:60915-1233
Practice Address - Country:US
Practice Address - Phone:815-932-9977
Practice Address - Fax:708-755-1470
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-038952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist