Provider Demographics
NPI:1558953232
Name:DONITA SCHREY PLLC
Entity Type:Organization
Organization Name:DONITA SCHREY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DONITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-414-6459
Mailing Address - Street 1:350 BOURBON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62707-2702
Mailing Address - Country:US
Mailing Address - Phone:217-414-6459
Mailing Address - Fax:618-392-1302
Practice Address - Street 1:MARKET STREET MEDICAL
Practice Address - Street 2:117 EAST MARKET STREET
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450
Practice Address - Country:US
Practice Address - Phone:618-392-1301
Practice Address - Fax:618-392-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center