Provider Demographics
NPI:1235452889
Name:SCHILKE, TAD (PHARMD)
Entity type:Individual
Prefix:
First Name:TAD
Middle Name:
Last Name:SCHILKE
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 1:8605 SANTA MONICA BLVD
Mailing Address - Street 2:PMB 64914
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4109
Mailing Address - Country:US
Mailing Address - Phone:608-690-8421
Mailing Address - Fax:515-612-9396
Practice Address - Street 1:3140 E AQUAMARINE AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7205
Practice Address - Country:US
Practice Address - Phone:608-690-8421
Practice Address - Fax:515-612-9396
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15224-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist