Provider Demographics
NPI:1194212399
Name:VICTOR C NEUMANN ASSOCIATION
Entity Type:Organization
Organization Name:VICTOR C NEUMANN ASSOCIATION
Other - Org Name:NEUMANN FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUGGEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-506-3201
Mailing Address - Street 1:5547 N RAVENSWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1125
Mailing Address - Country:US
Mailing Address - Phone:773-506-3201
Mailing Address - Fax:773-769-1476
Practice Address - Street 1:4122 N NASHVILLE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-1429
Practice Address - Country:US
Practice Address - Phone:773-769-4313
Practice Address - Fax:773-769-1476
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VICTOR C NEUMANN ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========003Medicaid