Healthcare Provider Details

I. General information

NPI: 1861810822
Provider Name (Legal Business Name): ABIGAIL NANCY SCHWAEDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2014
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

225 E CHICAGO AVE # 51
CHICAGO IL
60611-2991
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-3550
  • Fax:
Mailing address:
  • Phone: 312-227-3550
  • Fax: 312-227-9642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number036.149303
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: