Provider Information for 1467227058
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Mr. JOHN RANDALL SCHROEDER LCSW
Sex: Male
NPI: 1467227058
Last Updated: 2023-11-24
Certification Date: 2023-11-02
Certification Date: 2023-11-02
Details
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NPI | 1467227058 | ||||||||
Enumeration Date | 2023-11-24 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 3938 W 111TH ST APT 2A CHICAGO, IL 60655-4048 United States Phone: 708-890-9400 | Fax: | ||||||||
Primary Practice Address | 3938 W 111TH ST APT 2A CHICAGO, IL 60655-4048 United States Phone: 708-890-9400 | Fax: | ||||||||
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