Healthcare Provider Details

I. General information

NPI: 1366580763
Provider Name (Legal Business Name): BRIAN L SCHUMAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13520 SOUTH RTE. 59 SUITE 106
PLAINFIELD IL
60544
US

IV. Provider business mailing address

13520 SOUTH RTE. 59 SUITE 106
PLAINFIELD IL
60544
US

V. Phone/Fax

Practice location:
  • Phone: 815-254-1159
  • Fax: 815-254-1159
Mailing address:
  • Phone: 815-254-1159
  • Fax: 815-254-1159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070013955
License Number StateIL

VII. Legacy identifiers

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

# 1
Identifier567700
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerMEDICARE GROUP NUMBER
# 2
Identifier1619908
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerBCBS IL GROUP
# 3
Identifier568080
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerMEDICARE GROUP NUMBER
# 4
Identifier568150
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerMEDICARE GROUP NUMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: