Provider Demographics
NPI:1790123164
Name:SCHIEBER, ANN CAMERON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:CAMERON
Last Name:SCHIEBER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:CAMERON
Other - Last Name:HALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:275 PARKWAY DR STE 521
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-4344
Practice Address - Country:US
Practice Address - Phone:847-459-6400
Practice Address - Fax:847-459-4610
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
IL085.004727363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400097622Medicare Oscar/Certification