Basic Information
| Provider Information | |||||||||
| NPI: | 1558677211 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHMITT | ||||||||
| FirstName: | LEAH | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 440 E ROOSEVELT RD | ||||||||
| Address2: | STE 104 | ||||||||
| City: | WEST CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601853918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308769186 | ||||||||
| FaxNumber: | 6308769187 | ||||||||
| Practice Location | |||||||||
| Address1: | 440 E ROOSEVELT RD | ||||||||
| Address2: | STE 104 | ||||||||
| City: | WEST CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601853918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308769186 | ||||||||
| FaxNumber: | 6308769187 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2010 | ||||||||
| LastUpdateDate: | 10/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1197670 | TX | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 6553 | SC | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 070019696 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.