Provider Demographics
NPI:1124055835
Name:SCHAEFFER, CHRISTINE J (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:J
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:680 N LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-695-6868
Mailing Address - Fax:
Practice Address - Street 1:676 N SAINT CLAIR ST STE 2030
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2830
Practice Address - Country:US
Practice Address - Phone:773-562-3642
Practice Address - Fax:312-926-2200
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036101795207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH40211Medicare UPIN