Provider Demographics
NPI:1578518221
Name:SCHELBERT, VIRGINIA (ANP/CNP)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:
Last Name:SCHELBERT
Suffix:
Gender:F
Credentials:ANP/CNP
Other - Prefix:MRS
Other - First Name:VIRGINIA
Other - Middle Name:
Other - Last Name:SCHELBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP/CNP
Mailing Address - Street 1:2523 ASBURY AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2308
Mailing Address - Country:US
Mailing Address - Phone:847-328-3514
Mailing Address - Fax:773-728-8719
Practice Address - Street 1:2523 ASBURY AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2308
Practice Address - Country:US
Practice Address - Phone:847-328-3514
Practice Address - Fax:773-728-8719
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL41157737OtherCONTROLLED SUBSTANCE
ILK20742Medicare PIN
IL41157737OtherCONTROLLED SUBSTANCE
IL204517Medicare ID - Type UnspecifiedGROUP NUMBER