MEDICARE: SCHRECK THERAPY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1750999355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHRECK THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	5205 N WAYNE AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2242
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5205 N WAYNE AVE APT 2R
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2242
Country	:	US
Telephone Number	:	773-744-3449
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MS. HEIDI ANN SCHRECK
Credential	:	LCSW
Telephone Number	:	773-744-3449

Provider Enumeration Date	:	07/20/2020
Last Update Date	:	07/20/2020

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