Provider Demographics
NPI:1699281964
Name:SCHROEDER, ABIGAIL LYNN (MS, CCC-SLP/L)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:LYNN
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9815 W RADERS RD
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:IL
Mailing Address - Zip Code:61062-9737
Mailing Address - Country:US
Mailing Address - Phone:815-291-4855
Mailing Address - Fax:
Practice Address - Street 1:400 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:DAKOTA
Practice Address - State:IL
Practice Address - Zip Code:61018-9803
Practice Address - Country:US
Practice Address - Phone:844-632-5682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.12182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146.012182OtherSTATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONS SPEECH LA