Schmid Etienne
Individual provider Active NPI Contractor · Chicago, IL
NPI 1184078693 · NPPES record last updated Apr 20, 2016
Key facts
- NPI
- 1184078693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 1061 W Hollywood Ave
Apt B
Chicago, IL 60660-4550 - Phone
- (773) 310-4611
- NPI assigned
- Apr 20, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
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
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.