Provider Demographics
NPI:1013680560
Name:SCHULTZ, THOMAS THEODORE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:THEODORE
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 WILLIAM LATHAM DR STE 301
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-2450
Mailing Address - Country:US
Mailing Address - Phone:708-940-7133
Mailing Address - Fax:
Practice Address - Street 1:5000 S 5TH AVE BLDG 228
Practice Address - Street 2:
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-3030
Practice Address - Country:US
Practice Address - Phone:708-998-1361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0513040621835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy