Healthcare Provider Details

I. General information

NPI: 1053590455
Provider Name (Legal Business Name): CAROLYN SUE SCHAFER MA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ILLINOIS BLVD
HOFFMAN ESTATES IL
60169-3314
US

IV. Provider business mailing address

1 ILLINOIS BLVD.
HOFFMAN ESTATES IL
60194
US

V. Phone/Fax

Practice location:
  • Phone: 847-885-4060
  • Fax: 847-885-7846
Mailing address:
  • Phone: 847-885-4060
  • Fax: 847-885-7846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: