Provider Demographics
NPI:1851612410
Name:SCHUETT, CRYSTAL KAYE (APN/CNM)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:KAYE
Last Name:SCHUETT
Suffix:
Gender:F
Credentials:APN/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-1114
Mailing Address - Country:US
Mailing Address - Phone:708-352-1531
Mailing Address - Fax:
Practice Address - Street 1:233 W JOE ORR RD
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-1744
Practice Address - Country:US
Practice Address - Phone:708-709-7470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.000737367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife