Provider Demographics
NPI:1790104370
Name:SCHWINDENHAMMER, ANNA (PT DPT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SCHWINDENHAMMER
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S MAJOR ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:IL
Mailing Address - Zip Code:61530-1246
Mailing Address - Country:US
Mailing Address - Phone:309-304-2060
Mailing Address - Fax:
Practice Address - Street 1:101 S MAJOR ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:IL
Practice Address - Zip Code:61530-1246
Practice Address - Country:US
Practice Address - Phone:309-304-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014966225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist