Healthcare Provider Details
I. General information
NPI: 1073145728
Provider Name (Legal Business Name): MRS. MARGARET CANTARA SCHIFFHAUER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/11/2020
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
251 E HURON ST STE 16-738
CHICAGO IL
60611-2908
US
IV. Provider business mailing address
251 E HURON ST STE 16-738
CHICAGO IL
60611-2908
US
V. Phone/Fax
- Phone: 312-926-5924
- Fax: 312-926-6134
- Phone: 312-926-5924
- Fax: 312-926-6134
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 085008449 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: