Organization
NEUROLOGICAL SURGERY OF BELLEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E SCHULTZ SR. MD (CEO)
(618) 233-3330
Entity
Organization
Contact information
Practice address
340 WEST LINCOLN STREET, SUITE 540, BELLEVILLE, IL 62220
(618) 233-3330
(618) 233-3170
Mailing address
340 WEST LINCOLN STREET, SUITE 540, BELLEVILLE, IL 62220
(618) 233-3330
(618) 233-3170
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0336020691
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8232111
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/13/2006
Last updated
08/22/2020
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