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Individual

DR. JONATHAN MEYER SHAFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, APRN, PMHNP-BC

Contact information

Practice address
1203 W AUGUSTA BLVD STE 1, CHICAGO, IL 60642-4327
(773) 248-2255
Mailing address
14720 CHESTERFIELD TRAILS DR, CHESTERFIELD, MO 63017-5633

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2025007027
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.032353
IL

Other

Enumeration date
03/10/2025
Last updated
05/13/2025
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