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General NPI Number Information
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NPI Number | 1730420787
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Entity Type | Individual
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Provider Name | SIVAN SCHNEIDER PSYD
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Gender | Female
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Dates
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Enumeration Date | 03/14/2013
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Last Update Date | 06/09/2024
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Provider Practice Location Address
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Address Line | 800 W BUENA AVE FL 2 SMART LOVE FAMILY SERVICE
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City | CHICAGO
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State | IL
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Zip | 60613-1612
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Country | US
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Telephone | 773-665-8052
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Fax | 708-660-4301
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Provider Business Mailing Address
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Address Line | 4669 N MANOR AVE
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City | CHICAGO
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State | IL
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Zip | 60625-3717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071009840
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License Number State | IL
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