Provider Demographics
NPI:1841091535
Name:BISHOP, CHAD THOMAS
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:THOMAS
Last Name:BISHOP
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 11TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-6746
Mailing Address - Country:US
Mailing Address - Phone:309-788-4571
Mailing Address - Fax:
Practice Address - Street 1:4230 11TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-6746
Practice Address - Country:US
Practice Address - Phone:309-788-4571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)