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NPI Code Detail

MEDICARE: ALEXANDER SCHAEFER RPT

MEDICARE: ALEXANDER SCHAEFER RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT2174HI
2225100000XPhysical Therapist070012480IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A0238111OTHERHIHMSA, HMSA QUEST, 65CP
299017685996793OTHERHITRICARE CHAMPUS
3478143OTHERHIUHA

General Provider Information

NPI Number : 1407868318
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER SCHAEFER RPT
Provider Business Mailing Address
First Line : 2533 N SOUTHPORT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-7166
Country : US
Telephone Number : 773-472-2731
Fax Number : 773-472-2761
Provider Business Practice Location Address
First Line : 2533 N SOUTHPORT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-7166
Country : US
Telephone Number : 773-472-2731
Fax Number : 773-472-2761
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 11/26/2012

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Directions to “ ALEXANDER SCHAEFER RPT” Practice Location

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