Provider Demographics
NPI:1134308273
Name:SCHAFFER, DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 S CORNELL AVE
Mailing Address - Street 2:604
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4237
Mailing Address - Country:US
Mailing Address - Phone:312-926-0896
Mailing Address - Fax:773-667-8147
Practice Address - Street 1:5100 S CORNELL AVE
Practice Address - Street 2:604
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4237
Practice Address - Country:US
Practice Address - Phone:312-926-0896
Practice Address - Fax:773-667-8147
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical