Healthcare Provider Details

I. General information

NPI: 1093646689
Provider Name (Legal Business Name): NICHOLAS XAVIER SCHMITT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E HIGGINS RD
ELK GROVE VILLAGE IL
60007-1434
US

IV. Provider business mailing address

1649 VIRGINIA DR
ELK GROVE VILLAGE IL
60007-2953
US

V. Phone/Fax

Practice location:
  • Phone: 847-285-4200
  • Fax:
Mailing address:
  • Phone: 847-507-4350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160.020615
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: