Healthcare Provider Details

I. General information

NPI: 1629526371
Provider Name (Legal Business Name): ISAAC SCHAUF PT, DPT, LAT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1767 BURGOYNE CT
DE PERE WI
54115-7412
US

IV. Provider business mailing address

1767 BURGOYNE CT
DE PERE WI
54115-7412
US

V. Phone/Fax

Practice location:
  • Phone: 608-633-4630
  • Fax:
Mailing address:
  • Phone: 608-633-4630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2307-39
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17810-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: