Provider Demographics
NPI:1073761235
Name:SCHAFER, KATHERINE MASSURA (APRN, RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MASSURA
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:APRN, RN
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:SUZANNE
Other - Last Name:MASSURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:600 S PAULINA ST STE 1080
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3806
Mailing Address - Country:US
Mailing Address - Phone:312-942-9715
Mailing Address - Fax:312-942-6226
Practice Address - Street 1:600 S PAULINA ST
Practice Address - Street 2:SUITE 1080
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-942-9715
Practice Address - Fax:312-942-6226
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28154243A163WP0200X
IL041332518163WP0200X
IL209007103364SP0200X, 364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics