Individual
JACALYN K SCHWARZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2900 FRANK SCOTT PKWY W, SUITE 900, BELLEVILLE, IL 62223-5000
(618) 277-5700
(618) 257-7049
Mailing address
2900 FRANK SCOTT PKWY W, SUITE 900, BELLEVILLE, IL 62223-5000
(618) 277-5700
(618) 257-7049
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004290
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
016-004290
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101421
HEALTHLINK
IL
01
—
4226269
AETNA
IL
01
—
43090
GHP
—
01
—
480008831
MEDICARE RAILROAD PTAN
IL
01
—
STL2707000
UHC
—
Enumeration date
03/05/2006
Last updated
04/24/2012
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