Provider Demographics
NPI:1558318113
Name:SCHILL, LYNNE MARIE (MPT)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:MARIE
Last Name:SCHILL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1562 OPOSSUMTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4337
Mailing Address - Country:US
Mailing Address - Phone:240-566-3132
Mailing Address - Fax:
Practice Address - Street 1:400 W SEVENTH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4506
Practice Address - Country:US
Practice Address - Phone:240-566-3370
Practice Address - Fax:240-566-3796
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18975225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD768986-09OtherCAREFIRST OF MD
MD602030700OtherDEPT OF LABOR
MD443703OtherMAMSI
MDK134-0008OtherBC BS DC
MDPHCSOtherPHCS
MDR559-0011OtherBC BS DC
MD768986-10OtherCAREFIRST OF MD - MSS
MD147719000OtherDEPT OF LABOR
MD551810OtherMAMSI
MDR559-0011OtherBC BS DC
MDK134-0008OtherBC BS DC
MD034NN166Medicare ID - Type UnspecifiedMEDICARE - MSS