Healthcare Provider Details

I. General information

NPI: 1316779705
Provider Name (Legal Business Name): NEW LIFE MIDWEST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

991 FRANKLIN ST
CARLYLE IL
62231-1818
US

IV. Provider business mailing address

8440 CRYDER LANE CT
TROY IL
62294-1178
US

V. Phone/Fax

Practice location:
  • Phone: 618-610-1028
  • Fax: 618-417-6048
Mailing address:
  • Phone: 618-780-4605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: BRANDY JO SCHEER
Title or Position: CEO
Credential: APRN,MBA,MHA
Phone: 618-610-1028