Provider Demographics
NPI:1033356837
Name:SCHRAMM, JEANNE B (NP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:B
Last Name:SCHRAMM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 678691
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8691
Mailing Address - Country:US
Mailing Address - Phone:972-758-3598
Mailing Address - Fax:972-599-9604
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-7730
Practice Address - Fax:708-684-1028
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28135289A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200941850Medicaid
IN000000622248OtherANTHEM BCBS
IN200941850Medicaid
IN000000622248OtherANTHEM BCBS