Basic Information
| Provider Information | |||||||||
| NPI: | 1366580763 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHUMAN | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13520 SOUTH RTE. 59 | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | PLAINFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8152541159 | ||||||||
| FaxNumber: | 8152541159 | ||||||||
| Practice Location | |||||||||
| Address1: | 13520 SOUTH RTE. 59 | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | PLAINFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8152541159 | ||||||||
| FaxNumber: | 8152541159 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2007 | ||||||||
| LastUpdateDate: | 04/03/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 070013955 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 567700 | 01 | IL | MEDICARE GROUP NUMBER | OTHER | 1619908 | 01 | IL | BCBS IL GROUP | OTHER | 568080 | 01 | IL | MEDICARE GROUP NUMBER | OTHER | 568150 | 01 | IL | MEDICARE GROUP NUMBER | OTHER |