Provider Demographics
NPI:1689834426
Name:SCHWEIZER, LORI ANN (PT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:SCHWEIZER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:100 VALLEY CENTER RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2950
Practice Address - Country:US
Practice Address - Phone:302-994-1200
Practice Address - Fax:302-994-1233
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0000683225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
93888701OtherBC MARYLAND
5070-0099OtherGHMSI
DE1689834426Medicaid
3686720000OtherIBC AMERIHEALTH
DE256439Y0XMedicare PIN