Provider Demographics
NPI:1972161347
Name:SCHEMMEL, ROBIN GAYLE (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:GAYLE
Last Name:SCHEMMEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S CLARK ST FL 11
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-1882
Mailing Address - Country:US
Mailing Address - Phone:312-926-3627
Mailing Address - Fax:
Practice Address - Street 1:20 S CLARK ST FL 11
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-1882
Practice Address - Country:US
Practice Address - Phone:312-926-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
IL085007147363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1163424OtherNCCPA NUMBER