Provider Demographics
NPI:1679730766
Name:SCHNEIDMAN, SYDNEY W (MD, FACEP, FCEM)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:W
Last Name:SCHNEIDMAN
Suffix:
Gender:M
Credentials:MD, FACEP, FCEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N LAKE SHORE DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-8709
Mailing Address - Country:US
Mailing Address - Phone:312-695-0665
Mailing Address - Fax:
Practice Address - Street 1:1704 MAPLE AVE # 100
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3134
Practice Address - Country:US
Practice Address - Phone:312-694-2014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-18
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070799L207P00000X
IL036119428207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8600645Medicaid
C03973Medicare UPIN