Provider Demographics
NPI:1144735150
Name:SCHECTER, NOEL MICHAEL
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:MICHAEL
Last Name:SCHECTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-4309
Mailing Address - Country:US
Mailing Address - Phone:773-553-1800
Mailing Address - Fax:
Practice Address - Street 1:6676 N OGALLAH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1358
Practice Address - Country:US
Practice Address - Phone:773-818-8687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103218103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool