MEDICARE: SAMANTHA M SCHNEIDER OTR/L

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	225X00000X	Occupational Therapist	31007081A	IN

General Provider Information

NPI Number	:	1922632785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA M SCHNEIDER OTR/L

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-1980
Fax Number	:	630-928-5080

Provider Business Practice Location Address
First Line	:	1003 MILL POND DR STE C
Second Line	:
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-2609
Country	:	US
Telephone Number	:	765-653-8494
Fax Number	:	765-653-7835

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

Provider Enumeration Date	:	03/02/2020
Last Update Date	:	06/15/2021

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