Individual
MARTINE A. SCHULTHEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
621 ROXBURY RD, ROCKFORD, IL 61107-5077
(815) 397-3350
Mailing address
621 ROXBURY RD, ROCKFORD, IL 61107-5077
(815) 397-3350
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-136146
IL
390200000X
Student in an Organized Health Care Education/Training Program
125059864
IL
Other
Enumeration date
06/20/2011
Last updated
11/10/2015
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