MEDICARE: LYNN MARIE SCHMIDT M.S.,CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		IL

General Provider Information

NPI Number	:	1336161223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN MARIE SCHMIDT M.S.,CCC-SLP

Provider Business Mailing Address
First Line	:	1501 ELM ST
Second Line	:
City	:	SPRING GROVE
State	:	IL
Zip	:	60081-8002
Country	:	US
Telephone Number	:	815-675-2182
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 ELM ST
Second Line	:
City	:	SPRING GROVE
State	:	IL
Zip	:	60081-8002
Country	:	US
Telephone Number	:	815-675-2182
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	07/08/2007

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