Provider Demographics
NPI:1528107695
Name:SCHIFF, SUSAN (MSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:SCHIFF
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 N ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2225
Mailing Address - Country:US
Mailing Address - Phone:708-386-3170
Mailing Address - Fax:708-386-3170
Practice Address - Street 1:1515 N HARLEM AVE
Practice Address - Street 2:STE 205-14
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1205
Practice Address - Country:US
Practice Address - Phone:708-829-6023
Practice Address - Fax:708-386-3170
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2018-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490039481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL924510Medicare ID - Type Unspecified