Provider Demographics
NPI:1003065939
Name:SCHAEFER, JON LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:JON LYNN
Middle Name:
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 MULFORD ST APT 1S
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3334
Mailing Address - Country:US
Mailing Address - Phone:847-840-2812
Mailing Address - Fax:
Practice Address - Street 1:777 CENTRAL AVE.
Practice Address - Street 2:FAMILY SERVICES
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035
Practice Address - Country:US
Practice Address - Phone:847-432-4981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker