Active NPI
Matthew Roland Schardt, OTR/L
- Skilled Nursing Facility
- Wilmette, IL
National Provider Identifier
1194019687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 056.008416
- Practice address
- 1320 Maple Ave
Wilmette, IL 60091-2545 - Phone
- (847) 902-9535
- NPI assigned
- Jun 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 056.008416 | IL | Primary |
Addresses
Primary practice location
1320 Maple Ave
Wilmette, IL 60091-2545
Mailing address
1320 Maple Ave
Wilmette, IL 60091-2545
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.008416 | IL | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306972800000",
"number": "1194019687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 MAPLE AVE",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600912545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 MAPLE AVE",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600912545",
"telephone_number": "847-902-9535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHARDT",
"first_name": "MATTHEW",
"middle_name": "ROLAND",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-02",
"last_updated": "2011-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IL",
"license": "056.008416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmette, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.