Healthcare Provider Details

I. General information

NPI: 1740450170
Provider Name (Legal Business Name): S.M.A.R.T. LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 E WACKER DR 1607
CHICAGO IL
60601-5104
US

IV. Provider business mailing address

233 E WACKER DR 1607
CHICAGO IL
60601-5104
US

V. Phone/Fax

Practice location:
  • Phone: 312-804-0810
  • Fax: 312-650-5550
Mailing address:
  • Phone: 312-804-0810
  • Fax: 312-650-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberLP1686
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP 1686
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. DANIELA E SCHREIER
Title or Position: CEO
Credential: PSY.D.
Phone: 312-804-0810