Provider Demographics
NPI:1558415083
Name:SCHAFER, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:A
Other - Last Name:SCHAFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:555 CORPORATE WOODS PKWY
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-3111
Mailing Address - Country:US
Mailing Address - Phone:847-634-9400
Mailing Address - Fax:847-634-2900
Practice Address - Street 1:555 CORPORATE WOODS PKWY
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-3111
Practice Address - Country:US
Practice Address - Phone:847-634-9400
Practice Address - Fax:847-634-2900
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036112063207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036112603Medicaid
K20394Medicare ID - Type Unspecified
IL036112603Medicaid
IL212203Medicare PIN
IL212204Medicare PIN