Provider Demographics
NPI:1770051542
Name:SCHAIDLE, ANNE MARIE (RN)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:SCHAIDLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 DENNIS DR
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:IL
Mailing Address - Zip Code:61530-1691
Mailing Address - Country:US
Mailing Address - Phone:309-657-8815
Mailing Address - Fax:
Practice Address - Street 1:2471 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-1066
Practice Address - Country:US
Practice Address - Phone:309-229-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041456289163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse