Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 209-005251 | IL |
NPI | 1013053305 |
---|---|
Provider Name | Shari Anne Schrader |
First Address | Geneva, IL 60134-4200 |
Second Address | Geneva, IL 60134-4200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0387812-21 | ANCC CERTIFICATION (01) | ID |
209-005251 | ADVANCED PRACTICE LICENSE (01) | ID |
K23757 | (02) | IL |
MS1465980 | DEA (01) | IL |