Provider Demographics
NPI:1831230531
Name:SCHAD, JENNIFER (OD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:SCHAD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-2256
Mailing Address - Country:US
Mailing Address - Phone:231-591-2020
Mailing Address - Fax:231-591-3991
Practice Address - Street 1:1124 S STATE ST
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2256
Practice Address - Country:US
Practice Address - Phone:231-591-2020
Practice Address - Fax:231-591-3991
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004112152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU94677Medicare UPIN
MIN340400072Medicare PIN