Provider Demographics
NPI:1003007550
Name:SCHNEIDER, BROOKE ELLYN (MSED, BCBA)
Entity type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:ELLYN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:ELLYN
Other - Last Name:EINHORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1712
Mailing Address - Country:US
Mailing Address - Phone:312-927-1982
Mailing Address - Fax:
Practice Address - Street 1:4000 GROVE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1712
Practice Address - Country:US
Practice Address - Phone:312-927-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103K00000X
1-13-12819103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst