Provider Demographics
NPI:1154339430
Name:SCHMIDT, CHRIS W (MD)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:W
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 S 40TH CT
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-5817
Mailing Address - Country:US
Mailing Address - Phone:217-714-1421
Mailing Address - Fax:
Practice Address - Street 1:1729 S 40TH CT
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-5817
Practice Address - Country:US
Practice Address - Phone:217-714-1421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-108811207W00000X
IA21234207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108811 1Medicaid
279500OtherMEDICARE GROUP
P00044484OtherRAILROAD MEDICARE
P00044484OtherRAILROAD MEDICARE
IL036108811 1Medicaid
ILA02780Medicare UPIN