Provider Demographics
NPI:1356536569
Name:SCHUMACHER, ALLISON ROSE (DMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:ROSE
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:ROSE
Other - Last Name:CHAMNESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1 S 3RD ST.
Mailing Address - Street 2:
Mailing Address - City:ALTAMONT
Mailing Address - State:IL
Mailing Address - Zip Code:62411
Mailing Address - Country:US
Mailing Address - Phone:618-483-6003
Mailing Address - Fax:
Practice Address - Street 1:1 S 3RD ST.
Practice Address - Street 2:
Practice Address - City:ALTAMONT
Practice Address - State:IL
Practice Address - Zip Code:62411
Practice Address - Country:US
Practice Address - Phone:618-483-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070244148122300000X
IL019027384122300000X
MO207024148122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO405483009Medicaid