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NPI 1750161386

NPI 1750161386 : ASHLEY LEE SCHNEIDER-LAKIS RDH, PHDH : PEKIN, IL

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General NPI Number Information
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    NPI Number           |    1750161386
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    Entity Type          |    Individual 
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    Provider Name        |    ASHLEY LEE SCHNEIDER-LAKIS RDH, PHDH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/02/2023
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    Last Update Date     |    10/02/2023
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Provider Practice Location Address
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    Address Line         |    2424 N 8TH ST 
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    City                 |    PEKIN
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    State                |    IL
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    Zip                  |    61554-1547
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    Country              |    US
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    Telephone            |    309-382-6404
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4503 SILVIS RD 
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    City                 |    BARTONVILLE
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    State                |    IL
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    Zip                  |    61607-2666
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    Country              |    US
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    Telephone            |    309-360-3750
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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        |    124Q00000X
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    Taxonomy Name        |    Dental Hygienist
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    License Number       |    020.014426
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    License Number State |    IL
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