1326266784 NPI number — DR. VALERIE ANN SCHMIDT D.O.

Table of content: DR. VALERIE ANN SCHMIDT D.O. (NPI 1326266784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326266784 NPI number — DR. VALERIE ANN SCHMIDT D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMIDT
Provider First Name:
VALERIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326266784
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 E WISCONSIN AVE
Provider Second Line Business Mailing Address:
SUITE 2000
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53202-4815
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-290-6720
Provider Business Mailing Address Fax Number:
414-290-6755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 S MILWAUKEE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIBERTYVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60048-3204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-290-6720
Provider Business Practice Location Address Fax Number:
414-290-6755
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  4224 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 036.129150 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1326266784 . This is a "TRICARE NORTH REGION" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 200115820A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01078619 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 036129150 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".




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