Provider Demographics
NPI:1205278314
Name:SCHUH, ADRIENNE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:SCHUH
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 COUNTY ROAD 1650 N
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:IL
Mailing Address - Zip Code:62476-5207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1616 CEDAR ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62439-2154
Practice Address - Country:US
Practice Address - Phone:618-943-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009407225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist