MEDICARE: ROBIN GAYLE SCHEMMEL PA-C

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	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	085007147	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1163424	OTHER		NCCPA NUMBER

General Provider Information

NPI Number	:	1972161347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN GAYLE SCHEMMEL PA-C

Provider Business Mailing Address
First Line	:	20 S CLARK ST FL 11
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60603-1882
Country	:	US
Telephone Number	:	312-926-3627
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 S CLARK ST FL 11
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60603-1882
Country	:	US
Telephone Number	:	312-926-3627
Fax Number	:

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

Provider Enumeration Date	:	05/31/2019
Last Update Date	:	08/16/2019

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