Provider Demographics
NPI:1285728873
Name:SCHLAGETER, NICHOLAS L (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:L
Last Name:SCHLAGETER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 DEAN ST., SUITE D
Mailing Address - Street 2:
Mailing Address - City:ST. CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175
Mailing Address - Country:US
Mailing Address - Phone:630-587-2068
Mailing Address - Fax:630-587-2081
Practice Address - Street 1:2210 DEAN ST., SUITE D
Practice Address - Street 2:
Practice Address - City:ST. CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175
Practice Address - Country:US
Practice Address - Phone:630-587-2068
Practice Address - Fax:630-587-2081
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360608802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0005338653OtherAETNA
IL130017803OtherPALMETTO GBA - RAILROAD MEDICARE
IL130017803OtherPALMETTO GBA - RAILROAD MEDICARE
ILA76233Medicare UPIN