MEDICARE: MRS. ANGELA M. HAEN-SCHOENWALD MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146.008636	IL

General Provider Information

NPI Number	:	1477688323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA M. HAEN-SCHOENWALD MS

Provider Business Mailing Address
First Line	:	3140 N WILTON AVE
Second Line	:	2ND FL
City	:	CHICAGO
State	:	IL
Zip	:	60657-5193
Country	:	US
Telephone Number	:	773-296-8122
Fax Number	:	773-296-7281

Provider Business Practice Location Address
First Line	:	3140 N WILTON AVE.
Second Line	:	2ND FL
City	:	CHICAGO
State	:	IL
Zip	:	60657-5193
Country	:	US
Telephone Number	:	773-296-8122
Fax Number	:	773-296-7281

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	02/08/2010

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