Provider Demographics
NPI:1124451562
Name:SCHMIESING, AMBER ARLEEN
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:ARLEEN
Last Name:SCHMIESING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 N KENMORE AVE
Mailing Address - Street 2:301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3252 N KENMORE AVE
Practice Address - Street 2:301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3336
Practice Address - Country:US
Practice Address - Phone:507-382-7525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2528184222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist