Provider Demographics
NPI:1144376641
Name:SCHEFFLER, JOHN STEVEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEVEN
Last Name:SCHEFFLER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21316 BROWN DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9454
Mailing Address - Country:US
Mailing Address - Phone:815-464-0071
Mailing Address - Fax:815-469-4276
Practice Address - Street 1:21316 BROWN DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9454
Practice Address - Country:US
Practice Address - Phone:630-673-1872
Practice Address - Fax:815-469-4276
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL202605Medicare PIN
IL216028Medicare PIN
IL599100Medicare PIN
IL216032Medicare PIN
ILK48187Medicare PIN
ILK48131Medicare PIN