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General NPI Number Information
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NPI Number | 1770310070
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Entity Type | Organization
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Legal Business Name | SIVAN SCHNEIDER LLC
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 708 CHURCH ST STE 223
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City | EVANSTON
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State | IL
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Zip | 60201-3881
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Country | US
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Telephone | 312-493-7769
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Fax |
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Provider Business Mailing Address
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Address Line | 6321 DEMPSTER ST STE 104
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City | MORTON GROVE
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State | IL
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Zip | 60053-2848
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Country | US
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Telephone | 312-493-7769
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. SIVAN SCHNEIDER
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Credential | PSY.D.
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Telephone | 312-493-7769
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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 |
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License Number State |
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