Healthcare Provider Details

I. General information

NPI: 1598682346
Provider Name (Legal Business Name): AUSTIN SCHMIDT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 WINDWARD CT
NAPERVILLE IL
60563-2378
US

IV. Provider business mailing address

2043 CLARK ST APT 305
SAINT PETER MN
56082-7535
US

V. Phone/Fax

Practice location:
  • Phone: 920-532-1453
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number45571
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: