Provider Demographics
NPI:1497713028
Name:SCHMIDGALL, PATRICIA J (BSMHP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:J
Last Name:SCHMIDGALL
Suffix:
Gender:F
Credentials:BSMHP
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:J
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1423 VALLE VISTA
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554
Mailing Address - Country:US
Mailing Address - Phone:309-347-1148
Mailing Address - Fax:309-347-1298
Practice Address - Street 1:1423 VALLE VISTA BLVD
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-6223
Practice Address - Country:US
Practice Address - Phone:309-347-1148
Practice Address - Fax:309-347-1298
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health