Provider Demographics
NPI:1114005915
Name:SCHAFFER, STEVEN M (MA)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 LARKIN AVE
Mailing Address - Street 2:202
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123
Mailing Address - Country:US
Mailing Address - Phone:847-697-2400
Mailing Address - Fax:847-697-2438
Practice Address - Street 1:2050 LARKIN AVE
Practice Address - Street 2:202
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4405
Practice Address - Country:US
Practice Address - Phone:847-697-2400
Practice Address - Fax:847-697-2438
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional