MEDICARE: LACRETIA SCHWARTZ M.A.

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	103K00000X	Behavior Analyst	1-14-17568	IL

General Provider Information

NPI Number	:	1932532926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACRETIA SCHWARTZ M.A.

Provider Business Mailing Address
First Line	:	738 ARMY TRAIL ROAD
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-0001
Country	:	US
Telephone Number	:	815-469-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	738 ARMY TRAIL ROAD
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-0001
Country	:	US
Telephone Number	:	815-469-1500
Fax Number	:

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

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	06/06/2022

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