Healthcare Provider Details

I. General information

NPI: 1588242739
Provider Name (Legal Business Name): JACQUELINE SUE SCHAEFER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE
MILWAUKEE WI
53226-4874
US

IV. Provider business mailing address

8915 W CONNELL AVE STE 510
WAUWATOSA WI
53226-3067
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-3339
  • Fax:
Mailing address:
  • Phone: 414-266-2932
  • Fax: 414-266-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.152617
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number87502-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: