Philip William Schneeberger, CADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Broadview, IL
NPI 1154669059 · NPPES record last updated Jan 28, 2013
Key facts
- NPI
- 1154669059
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 21586 (IL)
- Practice address
- 1915 W Roosevelt Rd
Broadview, IL 60155-2925 - Phone
- (708) 344-3301
- Fax
- (708) 344-2944
- NPI assigned
- Jan 28, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21586 | IL | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 21586 | IL | Yes |
Addresses
Primary practice location
1915 W Roosevelt Rd
Broadview, IL 60155-2925
Mailing address
1915 W Roosevelt Rd
Broadview, IL 60155-2925
Phone (708) 344-3301
Other providers in Broadview, IL
- Sarah Jean Prokop
- Brian Louis Raymond
- Erin Reynolds
- Stacey Dianne Robertson
- Francisco Saucillo
- SCT Physicians
- Kimberly Dolores Serrano
- Brianna Simms
- Jackie E Skinner
- Gerald Lawrence Smith Jr.
All providers in Broadview, IL · Addiction (Substance Use Disorder) Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.