MEDICARE: DR KATHLEEN M SCHAFER DPM INC

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
1	213E00000X	Podiatrist	016004941	IL

General Provider Information

NPI Number	:	1780081984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR KATHLEEN M SCHAFER DPM INC

Provider Business Mailing Address
First Line	:	9230 BROADWAY AVE
Second Line	:
City	:	BROOKFIELD
State	:	IL
Zip	:	60513-1252
Country	:	US
Telephone Number	:	630-202-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	9230 BROADWAY AVE
Second Line	:
City	:	BROOKFIELD
State	:	IL
Zip	:	60513-1252
Country	:	US
Telephone Number	:	708-485-3668
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. PHILIP ANTHONY SCHAFER
Credential	:	CPA
Telephone Number	:	630-940-7708

Provider Enumeration Date	:	12/03/2014
Last Update Date	:	03/20/2019

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