Provider Demographics
NPI:1164477949
Name:SCHRAUTH, LINDA ANNE (PT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:SCHRAUTH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:SCHRAUTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1635 HAWTHORNE LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2262
Mailing Address - Country:US
Mailing Address - Phone:847-998-9682
Mailing Address - Fax:847-998-6476
Practice Address - Street 1:910A WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-4315
Practice Address - Country:US
Practice Address - Phone:847-657-0881
Practice Address - Fax:847-657-0880
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1635017OtherBCBS PROVIDER NUMBER
1635017OtherBCBS PROVIDER NUMBER