Provider Demographics
NPI:1740543677
Name:SCHMIDT, JEAN (MS, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 GOLF MILL CTR
Mailing Address - Street 2:SUITE 201-203
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1224
Mailing Address - Country:US
Mailing Address - Phone:847-699-9757
Mailing Address - Fax:
Practice Address - Street 1:241 GOLF MILL CTR
Practice Address - Street 2:SUITE 201-203
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1224
Practice Address - Country:US
Practice Address - Phone:847-699-9757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242002241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist