Individual
PETER SCHLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 W PARK ST, URBANA, IL 61801-2334
(217) 337-2000
Mailing address
PO BOX 532912, ATLANTA, GA 30353-2912
(217) 337-2000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032044
BCBS
IL
05
—
36062421
—
IL
01
—
DA9787
RR MEDICARE GROUP
IL
01
—
P00034184
RR MEDICARE
IL
Enumeration date
11/15/2006
Last updated
10/18/2007
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