Provider Demographics
NPI:1265618870
Name:SCHMITT, VICTORIA (NP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARIA VICTORIA
Other - Middle Name:D
Other - Last Name:FAUSTINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:35 E LEXINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-9638
Mailing Address - Country:US
Mailing Address - Phone:630-267-2627
Mailing Address - Fax:630-503-6600
Practice Address - Street 1:35 E LEXINGTON CIR
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-9638
Practice Address - Country:US
Practice Address - Phone:630-708-6941
Practice Address - Fax:630-503-6600
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277.000560363LP0808X
IL209006796363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid
IL$$$$$$$$$001Medicaid