Provider Demographics
NPI:1366656035
Name:SCHNEIDER, DANA FLYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:FLYNN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:ANN
Other - Last Name:FLYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1171 GUNDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2150
Mailing Address - Country:US
Mailing Address - Phone:708-358-1644
Mailing Address - Fax:
Practice Address - Street 1:1200 HARGER RD
Practice Address - Street 2:SUITE 505
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1805
Practice Address - Country:US
Practice Address - Phone:708-790-8619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical