MEDICARE: DR. KEITH WAYNE SCHMIDT M.D.

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	207L00000X	Anesthesiology Physician	036131807	IL
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	036131807	IL
3	208VP0000X	Pain Medicine Physician	036131807	IL

General Provider Information

NPI Number	:	1407162746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH WAYNE SCHMIDT M.D.

Provider Business Mailing Address
First Line	:	1555 BARRINGTON RD STE 2400
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1063
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 BARRINGTON RD STE 2400
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1063
Country	:	US
Telephone Number	:	847-981-3630
Fax Number	:

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

Provider Enumeration Date	:	08/24/2010
Last Update Date	:	03/29/2021

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