Provider Demographics
NPI:1316223589
Name:SCHAAFSMA, DREW (PA-C, ATC)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:SCHAAFSMA
Suffix:
Gender:M
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 ROLLINGRIDGE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4234
Mailing Address - Country:US
Mailing Address - Phone:630-579-6500
Mailing Address - Fax:630-718-6075
Practice Address - Street 1:2940 ROLLINGRIDGE RD STE 102
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4234
Practice Address - Country:US
Practice Address - Phone:630-579-6500
Practice Address - Fax:630-718-6075
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960027132255A2300X
IL085004945363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL085004945OtherPHYSICIAN ASSISTANT LICENSE