Healthcare Provider Details

I. General information

NPI: 1235890419
Provider Name (Legal Business Name): JOSEPH J SCHMITT HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 WILLIAMSON COUNTY PKWY STE J
MARION IL
62959-5271
US

IV. Provider business mailing address

615 N MAIN ST
O FALLON IL
62269-3704
US

V. Phone/Fax

Practice location:
  • Phone: 618-997-5856
  • Fax: 618-997-5856
Mailing address:
  • Phone: 618-624-4471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3440
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: