Provider Demographics
NPI:1578028551
Name:SCHAUB, ALEXANDRIA S
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:S
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6625 W CHALLACOMBE RD
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:IL
Mailing Address - Zip Code:61528-9739
Mailing Address - Country:US
Mailing Address - Phone:309-634-8656
Mailing Address - Fax:
Practice Address - Street 1:6625 W CHALLACOMBE RD
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:IL
Practice Address - Zip Code:61528-9739
Practice Address - Country:US
Practice Address - Phone:309-634-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer