Active NPI
Schmid Etienne
- Contractor
- Chicago, IL
National Provider Identifier
1184078693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 1061 W Hollywood Ave
Apt B
Chicago, IL 60660-4550 - Phone
- (773) 310-4611
- NPI assigned
- Apr 20, 2016
- Last updated
- Apr 20, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
1061 W Hollywood Ave
Apt B
Chicago, IL 60660-4550
Mailing address
1061 W Hollywood Ave
Apt B
Chicago, IL 60660-4550
Phone (773) 310-4611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1184078693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 W HOLLYWOOD AVE",
"address_2": "APT B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606604550",
"telephone_number": "773-310-4611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 W HOLLYWOOD AVE",
"address_2": "APT B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606604550",
"telephone_number": "773-310-4611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE",
"first_name": "SCHMID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-20",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.