Provider Demographics
NPI:1912383548
Name:SCHNEIDER, DANIELLE E (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 W SIENNA LN
Mailing Address - Street 2:2302
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-7871
Mailing Address - Country:US
Mailing Address - Phone:317-443-2317
Mailing Address - Fax:
Practice Address - Street 1:1919 W PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-1825
Practice Address - Country:US
Practice Address - Phone:309-443-2317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051298737183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist