Provider Demographics
NPI:1346292075
Name:SCHUM, ROBERT L (PHD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:SCHUM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 W NORTH AVE
Mailing Address - Street 2:CHILD DEVELOPMENT CENTER OF CHW
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4977
Mailing Address - Country:US
Mailing Address - Phone:262-432-6626
Mailing Address - Fax:262-432-6604
Practice Address - Street 1:13800 W NORTH AVE
Practice Address - Street 2:CHILD DEVELOPMENT CENTER OF CHW
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4977
Practice Address - Country:US
Practice Address - Phone:262-432-6626
Practice Address - Fax:262-432-6604
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1881103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
002000218FOtherHUMANA
WI39110700Medicaid
WI1346292075Medicaid
R59279Medicare UPIN
WI39110700Medicaid
002000218FOtherHUMANA