Individual
THERESA SCHAFER NUESTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1725 W HARRISON ST, SUITE 1010, CHICAGO, IL 60612-3841
(312) 942-6300
(312) 942-6301
Mailing address
1725 W HARRISON ST, SUITE 848, CHICAGO, IL 60612-3841
(312) 942-6300
(312) 942-6301
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003065
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085003065
DEPT. OF PROFESSIONAL REGULATION
IL
Enumeration date
09/22/2008
Last updated
03/26/2013
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