1336761766 NPI number — ANITA SCHMIDT COUNSELING, INC.

Table of content: (NPI 1336761766)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336761766 NPI number — ANITA SCHMIDT COUNSELING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANITA SCHMIDT COUNSELING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1336761766
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
825 S WAUKEGAN ROAD
Provider Second Line Business Mailing Address:
SUITE A8 PMB 1079
Provider Business Mailing Address City Name:
LAKE FOREST
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60045-6004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-786-5682
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 S WAUKEGAN ROAD
Provider Second Line Business Practice Location Address:
SUITE A8 PMB 1079
Provider Business Practice Location Address City Name:
LAKE FOREST
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60045-6004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-786-5682
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2020

Additional Information

Authorized Official

Authorized Official Last Name:
SCHMIDT
Authorized Official First Name:
ANITA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
847-786-5682

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: F300420002 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com