Basic Information
Provider Information
NPI: 1932541844
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMINK
FirstName: ABIGAIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7410264
Address2:  
City: CHICAGO
State: IL
PostalCode: 606740264
CountryCode: US
TelephoneNumber: 8159426323
FaxNumber: 7792105541
Practice Location
Address1: 1401 LAKEWOOD DR STE A
Address2:  
City: MORRIS
State: IL
PostalCode: 604503352
CountryCode: US
TelephoneNumber: 8159426323
FaxNumber: 7792105541
Other Information
ProviderEnumerationDate: 07/19/2013
LastUpdateDate: 02/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X  Y Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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