Provider Demographics
NPI:1841471083
Name:SHAEFFER, DENISE M (PHD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:M
Last Name:SHAEFFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7101 N CICERO AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2112
Mailing Address - Country:US
Mailing Address - Phone:773-457-9788
Mailing Address - Fax:773-296-3226
Practice Address - Street 1:7101 N CICERO AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2112
Practice Address - Country:US
Practice Address - Phone:773-457-9788
Practice Address - Fax:773-296-3226
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2014-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007512103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical