Healthcare Provider Details

I. General information

NPI: 1124606058
Provider Name (Legal Business Name): CHRISTOPHER JAMES SCHIMMOELLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

26420 LAUREL LN
PERRYSBURG OH
43551-5484
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-4415
  • Fax:
Mailing address:
  • Phone: 419-494-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number34.018608
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: