Healthcare Provider Details

I. General information

NPI: 1891739082
Provider Name (Legal Business Name): SUZANNE MARIE SCHMIDT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE MARIE SZCZEPANIAK MD

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CHILDRENS PLAZA
CHICAGO IL
60614
US

IV. Provider business mailing address

2035 W WARNER AVE
CHICAGO IL
60618
US

V. Phone/Fax

Practice location:
  • Phone: 312-573-4512
  • Fax: 312-573-8400
Mailing address:
  • Phone: 773-880-8245
  • Fax: 773-880-8267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: