Healthcare Provider Details

I. General information

NPI: 1225906662
Provider Name (Legal Business Name): SANDRA SCHRODER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12151 REGENCY PKWY STE 12165
HUNTLEY IL
60142-7644
US

IV. Provider business mailing address

12151 REGENCY PKWY STE 12165
HUNTLEY IL
60142-7644
US

V. Phone/Fax

Practice location:
  • Phone: 847-230-9808
  • Fax: 847-984-1915
Mailing address:
  • Phone: 847-230-9808
  • Fax: 847-984-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.033307
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: