Provider Demographics
NPI:1528274198
Name:SCHECHTER, LOREN S (MD)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:S
Last Name:SCHECHTER
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 1:9000 WAUKEGAN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2127
Mailing Address - Country:US
Mailing Address - Phone:847-967-5122
Mailing Address - Fax:847-967-5125
Practice Address - Street 1:9000 WAUKEGAN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2127
Practice Address - Country:US
Practice Address - Phone:847-967-5122
Practice Address - Fax:847-967-5125
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-094473174400000X
IL0360944732086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HO4608Medicare UPIN
207583Medicare ID - Type Unspecified