Individual provider Active NPI

Edwin W. Schaefer, N.P.

  • Nurse Practitioner
  • Geneva, IL
National Provider Identifier
1679651228
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Practice address
300 Randall Rd
Emergency Dept
Geneva, IL 60134-4200
Phone
(630) 208-4009
Fax
(630) 208-0942
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X IL Primary

Addresses

Primary practice location

300 Randall Rd
Emergency Dept
Geneva, IL 60134-4200

Mailing address

PO Box 9030
Wheeling, IL 60090-9030
Phone (847) 495-1617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117000082 IL Practitioner - Nurse Practitioner 7517921745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Emergency Care Management IncGroup PAC ID 1850387713, 11 clinicians

Practice addresses (Care Compare)

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 208-4009

Hospital & facility affiliations

  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Nov 2, 2015 Accepting new patients
Fastrac Medical, P.C. Past Accepting new patients
Tri County Anesthesia S.C. Past Accepting new patients
Pic Wisconsin SC PastSince Sep 25, 2019 Accepting new patients

Locations

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

2490 Bushwood Dr
Elgin, IL 60124
Phone (224) 293-5200

750 Essington Rd
Joliet, IL 60435
Phone (815) 729-2160

3475 S Alpine Rd
Rockford, IL 61109
Phone (815) 874-8000

9701 W Higgins Rd
Ste 270
Rosemont, IL 60018
Phone (847) 653-0130

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679651228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9030",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600909030",
            "telephone_number": "847-495-1617",
            "fax_number": "847-537-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RANDALL RD",
            "address_2": "EMERGENCY DEPT",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344200",
            "telephone_number": "630-208-4009",
            "fax_number": "630-208-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "EDWIN",
        "middle_name": "W.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.