Healthcare Provider Details

I. General information

NPI: 1679285282
Provider Name (Legal Business Name): JESSICA SCHROEDER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2022
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5314 SUNMEADOW DR
PLAINFIELD IL
60586-7587
US

IV. Provider business mailing address

5314 SUNMEADOW DR
PLAINFIELD IL
60586-7587
US

V. Phone/Fax

Practice location:
  • Phone: 708-248-4934
  • Fax:
Mailing address:
  • Phone: 708-248-4934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JESSICA SCHROEDER
Title or Position: CLINICAL MENTAL HEALTH THERAPIST
Credential: LCPC
Phone: 708-248-4934