Healthcare Provider Details

I. General information

NPI: 1013657907
Provider Name (Legal Business Name): NICOLE SCHMIDT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N ADDISON AVE
ELMHURST IL
60126-2857
US

IV. Provider business mailing address

PO BOX 713260
CHICAGO IL
60677-1260
US

V. Phone/Fax

Practice location:
  • Phone: 630-832-3100
  • Fax: 630-832-1604
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-172158
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: