Provider Demographics
NPI:1982107322
Name:WALDSCHMIDT, GENEVIEVE ANNE (FPA-APN)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:ANNE
Last Name:WALDSCHMIDT
Suffix:
Gender:F
Credentials:FPA-APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 27TH ST
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-2542
Mailing Address - Country:US
Mailing Address - Phone:847-377-8382
Mailing Address - Fax:847-984-5619
Practice Address - Street 1:1911 27TH ST
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-2542
Practice Address - Country:US
Practice Address - Phone:847-377-8800
Practice Address - Fax:847-984-5619
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277001957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily