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Individual

THOMAS SCHAEFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1324 N SHERIDAN RD, WAUKEGAN, IL 60085-2161
(847) 360-4181
Mailing address
475 JOHELIA TRL, ANTIOCH, IL 60002-2507
(847) 502-2376

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.471722
IL
363L00000X
Nurse Practitioner
Primary
209.025276
IL

Other

Enumeration date
03/29/2022
Last updated
06/05/2022
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