Provider Demographics
NPI:1073521365
Name:SCHMITZ, SHEILA R (ANP)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:R
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3909
Mailing Address - Country:US
Mailing Address - Phone:217-366-1326
Mailing Address - Fax:217-366-6106
Practice Address - Street 1:1801 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-6217
Practice Address - Country:US
Practice Address - Phone:217-366-6104
Practice Address - Fax:217-366-6106
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209000311363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
433990OtherMEDICARE GROUP
500019110OtherRAILROAD MEDICARE
L86617Medicare PIN
500019110OtherRAILROAD MEDICARE
433990OtherMEDICARE GROUP