Provider Demographics
NPI:1497713077
Name:BISCHOFF, DANA A D (MA CSADC)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:A D
Last Name:BISCHOFF
Suffix:
Gender:F
Credentials:MA CSADC
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:A
Other - Last Name:DRAPEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:100 N MAIN
Mailing Address - Street 2:SUITE L100
Mailing Address - City:EAST PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61611
Mailing Address - Country:US
Mailing Address - Phone:309-694-6462
Mailing Address - Fax:309-694-7812
Practice Address - Street 1:100 N MAIN
Practice Address - Street 2:SUITE L100
Practice Address - City:EAST PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61611
Practice Address - Country:US
Practice Address - Phone:309-694-6462
Practice Address - Fax:309-694-7812
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL23583101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)