Provider Demographics
NPI:1225017718
Name:SCHULZ, KIMBERLY K (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:K
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 6TH ST
Mailing Address - Street 2:202
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1755
Mailing Address - Country:US
Mailing Address - Phone:319-337-4566
Mailing Address - Fax:319-337-4766
Practice Address - Street 1:1000 36TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-7141
Practice Address - Country:US
Practice Address - Phone:319-400-0477
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2025-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036144381207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA45613OtherBCBS INDIVIDUAL NUMBER
IA17542OtherBCBS GROUP NUMBER
IA2208108Medicaid
IA391894814-01OtherJOHN DEERE HEALTH NUMBER
IA45613OtherBCBS INDIVIDUAL NUMBER
IA2208108Medicaid