Provider Demographics
NPI:1366580763
Name:SCHUMAN, BRIAN L (PT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:L
Last Name:SCHUMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13520 SOUTH RTE. 59
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544
Mailing Address - Country:US
Mailing Address - Phone:815-254-1159
Mailing Address - Fax:815-254-1159
Practice Address - Street 1:13520 SOUTH RTE. 59
Practice Address - Street 2:SUITE 106
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544
Practice Address - Country:US
Practice Address - Phone:815-254-1159
Practice Address - Fax:815-254-1159
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070013955225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL567700OtherMEDICARE GROUP NUMBER
IL1619908OtherBCBS IL GROUP
IL568080OtherMEDICARE GROUP NUMBER
IL568150OtherMEDICARE GROUP NUMBER