Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 1871560961 | IL |
Y | 2080P0214X | Pediatric Pulmonologist | 036155682 | IL |
NPI | 1326531575 |
---|---|
Provider Name | Henry Schmidt |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2018 |
Last Update Date | 02/07/2021 |