Provider Demographics
NPI:1235890419
Name:SCHMITT, JOSEPH J (HIS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:SCHMITT
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-3704
Mailing Address - Country:US
Mailing Address - Phone:618-624-4471
Mailing Address - Fax:
Practice Address - Street 1:2406 WILLIAMSON COUNTY PKWY STE J
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5271
Practice Address - Country:US
Practice Address - Phone:618-997-5856
Practice Address - Fax:618-997-5856
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3440237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist