Provider Demographics
NPI:1871952556
Name:SCHNEIDER, AVA (MA)
Entity type:Individual
Prefix:MS
First Name:AVA
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-4929
Mailing Address - Country:US
Mailing Address - Phone:847-570-2048
Mailing Address - Fax:847-733-5042
Practice Address - Street 1:2650 RIDGE AVE EVANSTON HOSPITAL
Practice Address - Street 2:DEPT OF REHABILIATION SERVICES- ROOM 2217- LOUIS
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:847-570-2048
Practice Address - Fax:847-733-5042
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146001470235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist