Provider Demographics
NPI:1861901803
Name:SCHRADER, CHRISTAN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTAN
Middle Name:
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4670 11TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61244-4428
Mailing Address - Country:US
Mailing Address - Phone:309-796-2500
Mailing Address - Fax:
Practice Address - Street 1:4670 11TH ST
Practice Address - Street 2:
Practice Address - City:EAST MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61244-4428
Practice Address - Country:US
Practice Address - Phone:309-796-2500
Practice Address - Fax:309-796-2500
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146005209235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist