Provider Demographics
NPI:1326151333
Name:SCHWARZTRAUBER, LISA (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SCHWARZTRAUBER
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 OAKMONT LN
Mailing Address - Street 2:STE 600C
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:2315 DOUGHERTY FERRY RD.
Practice Address - Street 2:STE 109
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63122-3356
Practice Address - Country:US
Practice Address - Phone:314-238-1130
Practice Address - Fax:314-238-1132
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000540225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO219951806Medicare ID - Type Unspecified