Provider Demographics
NPI:1598650053
Name:SCHMIDT, KELLI LYNN (APRN)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:LYNN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 DUNDEE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-4218
Mailing Address - Country:US
Mailing Address - Phone:847-977-6027
Mailing Address - Fax:847-977-6027
Practice Address - Street 1:809 DUNDEE AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-4218
Practice Address - Country:US
Practice Address - Phone:847-977-6027
Practice Address - Fax:847-977-6027
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209032433363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health