Provider Demographics
NPI:1568670859
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:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SELDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-769-4313
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:
Practice Address - Street 1:2728 W LELAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3706
Practice Address - Country:US
Practice Address - Phone:773-303-0195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VICTOR C. NEUMANN ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-18
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251S00000X
IL199100067C320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========022Medicaid