Provider Demographics
NPI:1386460236
Name:SCHACHT, ALLISON
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SCHACHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 N ORCHARD ST APT 709
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5243
Mailing Address - Country:US
Mailing Address - Phone:317-397-1235
Mailing Address - Fax:
Practice Address - Street 1:3001 N SOUTHPORT AVE FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4289
Practice Address - Country:US
Practice Address - Phone:773-799-8966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL37968101YA0400X
IL178019393101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)