Provider Demographics
NPI:1750161386
Name:SCHNEIDER-LAKIS, ASHLEY LEE (RDH, PHDH)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LEE
Last Name:SCHNEIDER-LAKIS
Suffix:
Gender:F
Credentials:RDH, PHDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 SILVIS RD
Mailing Address - Street 2:
Mailing Address - City:BARTONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61607-2666
Mailing Address - Country:US
Mailing Address - Phone:309-360-3750
Mailing Address - Fax:
Practice Address - Street 1:2424 N 8TH ST
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-1547
Practice Address - Country:US
Practice Address - Phone:309-382-6404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL020.014426124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist