Provider Demographics
NPI:1104663483
Name:SCHAFFER, ABBY (MS)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 PINE ST
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4006
Mailing Address - Country:US
Mailing Address - Phone:847-804-9288
Mailing Address - Fax:
Practice Address - Street 1:422 N NORTHWEST HWY STE 210
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3273
Practice Address - Country:US
Practice Address - Phone:847-699-9757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.007785235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist