Healthcare Provider Details
I. General information
NPI: 1144438433
Provider Name (Legal Business Name): VICTOR C. NEUMANN ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2007
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2646 N WASHTENAW AVE
CHICAGO IL
60647-1836
US
IV. Provider business mailing address
5547 N RAVENSWOOD AVE
CHICAGO IL
60640-1125
US
V. Phone/Fax
- Phone: 773-235-5861
- Fax:
- Phone: 773-506-3201
- Fax: 773-769-1476
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
EILEEN
DURKIN
Title or Position: CEO
Credential:
Phone: 773-769-4313