Individual
DR. MARY JEAN SCHAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
225 N JACKSON ST, BELLEVILLE, IL 62220-1308
(618) 233-6405
(618) 233-6424
Mailing address
225 N JACKSON ST, BELLEVILLE, IL 62220-1308
(618) 233-6405
(618) 233-6424
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19-18650
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-18650
ILLINOIS STATE LICENSE
IL
Enumeration date
11/15/2006
Last updated
07/08/2007
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