Provider Demographics
NPI:1861896482
Name:SCHUMACHER, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 W AGATITE AVE
Mailing Address - Street 2:#3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6127
Mailing Address - Country:US
Mailing Address - Phone:773-952-1604
Mailing Address - Fax:
Practice Address - Street 1:850 W AGATITE AVE
Practice Address - Street 2:#3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-6127
Practice Address - Country:US
Practice Address - Phone:773-952-1604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490166481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical