Provider Demographics
NPI:1366644502
Name:SCHAEFER, RONALD W (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:W
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1306 E ARNOLD ST
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-1283
Mailing Address - Country:US
Mailing Address - Phone:773-343-2164
Mailing Address - Fax:815-786-2067
Practice Address - Street 1:4017 E 2603RD RD
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:IL
Practice Address - Zip Code:60551-9502
Practice Address - Country:US
Practice Address - Phone:773-343-2164
Practice Address - Fax:815-786-2067
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine