Healthcare Provider Details

I. General information

NPI: 1154539443
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: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6131 N ROCKWELL ST
CHICAGO IL
60659-2701
US

IV. Provider business mailing address

5547 N RAVENSWOOD AVE
CHICAGO IL
60640-1125
US

V. Phone/Fax

Practice location:
  • Phone: 773-743-1647
  • Fax:
Mailing address:
  • Phone: 773-506-3201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL SELDEN
Title or Position: CEO
Credential: PH.D.
Phone: 773-769-4313