Organization Active NPI

Neurological Surgery of Belleville

  • Neurological Surgery Physician
  • Belleville, IL
National Provider Identifier
1841361623
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
0336020691 Issued in IL
Legal business name
NEUROLOGICAL SURGERY OF BELLEVILLE
Practice address
340 West Lincoln Street
Suite 540
Belleville, IL 62220
Phone
(618) 233-3330
Fax
(618) 233-3170
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert E Schultz Sr., MD
Title
Ceo
Phone
(618) 233-3330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X 0336020691 IL Primary

Addresses

Primary practice location

340 West Lincoln Street
Suite 540
Belleville, IL 62220

Mailing address

340 West Lincoln Street
Suite 540
Belleville, IL 62220
Phone (618) 233-3330

Other identifiers 1

IdentifierTypeStateIssuer
8232111OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841361623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 WEST LINCOLN STREET",
            "address_2": "SUITE 540",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62220",
            "telephone_number": "618-233-3330",
            "fax_number": "618-233-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 WEST LINCOLN STREET",
            "address_2": "SUITE 540",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62220",
            "telephone_number": "618-233-3330",
            "fax_number": "618-233-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL SURGERY OF BELLEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-233-3330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "0336020691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8232111",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.