Provider Demographics
NPI:1821778630
Name:SCHAUB, KRISANNE
Entity Type:Individual
Prefix:
First Name:KRISANNE
Middle Name:
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 TARTAN RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1529
Mailing Address - Country:US
Mailing Address - Phone:201-312-5278
Mailing Address - Fax:
Practice Address - Street 1:7900 N MILWAUKEE AVE STE 7
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3172
Practice Address - Country:US
Practice Address - Phone:847-595-1945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist