Individual provider Active NPI

David J Schlagheck, MD

  • Family Medicine Physician
  • Spring Valley, IL
National Provider Identifier
1336255157
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036059055 Issued in IL
Practice address
600 E 1St St
Spring Valley, IL 61362-1512
Phone
(815) 663-2811
Fax
(815) 664-5001
NPI assigned
Aug 22, 2006
Last updated
Aug 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036059055 IL Primary

Addresses

Primary practice location

600 E 1St St
Spring Valley, IL 61362-1512

Mailing address

600 E 1St St
Spring Valley, IL 61362-1512
Phone (815) 663-2811

Other identifiers 1

IdentifierTypeStateIssuer
036059055MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036059055ILMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1336255157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 1ST ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621512",
            "telephone_number": "815-663-2811",
            "fax_number": "815-664-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 1ST ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621512",
            "telephone_number": "815-663-2811",
            "fax_number": "815-664-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLAGHECK",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036059055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059055",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.