Schonewolf, Scott K

Schonewolf, Scott K is an individual health care provider with primary practice located at 305 W Jackson St Suite 200, Carbondale IL 62901. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Schonewolf, Scott K can be contacted via phone (618) 453-3777.

Contact Information

Primary practice address
305 W Jackson St Suite 200 Carbondale IL 62901
Fax: (618) 453-1102
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036-114842 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-114842 Illinois

Profile Details

NPI number 1114996204
LBN Legal business name Schonewolf, Scott K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Dec 9th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114996204 NPPES
Illinois MEDICAID 036114842

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