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General NPI Number Information
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NPI Number | 1023499787
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Entity Type | Individual
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Provider Name | ADRIANA SCHMIDT
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Gender | Female
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 85 REVERE DR AA
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City | NORTHBROOK
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State | IL
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Zip | 60062-8001
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Country | US
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Telephone | 847-564-0822
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Fax |
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Provider Business Mailing Address
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Address Line | 206 S WHEELING RD
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City | PROSPECT HEIGHTS
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State | IL
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Zip | 60070-2557
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Country | US
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Telephone | 224-612-2867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-15-18473
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License Number State | IL
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