Individual
DR. GORDON ANTHONY SCHULZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY D
Contact information
Practice address
20121 CRAWFORD AVE, OLYMPIA FIELDS, IL 60461-1009
(708) 756-1200
Mailing address
35318 EAGLE WAY, CHICAGO, IL 60678-1353
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071005343
IL
103TC0700X
Clinical Psychologist
20042090A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090001287
BLUE CROSS BLUE SHIELD
IL
01
—
4673170001
DMERC GROUP
IL
01
—
IL5686039
MEDICARE PTAN
IL
01
—
P00439470/CK6882
RAILROAD MEDICARE
IL
Enumeration date
11/27/2006
Last updated
03/20/2021
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