Healthcare Provider Details

I. General information

NPI: 1013653179
Provider Name (Legal Business Name): DANIELLE SCHRAMM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8464 E FRONTIER CIR
SAINT GERMAIN WI
54558-9417
US

IV. Provider business mailing address

8464 E FRONTIER CIR
SAINT GERMAIN WI
54558-9417
US

V. Phone/Fax

Practice location:
  • Phone: 847-630-6794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: