Provider Demographics
NPI:1831574847
Name:SCHMITTGENS, ANDREA RAE
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:RAE
Last Name:SCHMITTGENS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:RAE
Other - Last Name:BERMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 W SCHOOL ST APT 210
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2141
Mailing Address - Country:US
Mailing Address - Phone:630-740-1466
Mailing Address - Fax:
Practice Address - Street 1:1601 W SCHOOL ST APT 210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2141
Practice Address - Country:US
Practice Address - Phone:630-740-1466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146.013164OtherSTATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION