George Kenneth Shotick in Peoria - Family Medicine

George Kenneth Shotick - NPI 1104941657

George Kenneth Shotick is a Family Medicine in Peoria, Illinois. George Kenneth Shotick practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for George Kenneth Shotick is 1104941657. The last update date is 2016-02-15.

George Kenneth Shotick's current location address is 228 Ne Jefferson Ave, Peoria, Illinois. You can contact this provider via phone number 3096718000 and fax number 3096714695. The mailing address for George Kenneth Shotick is 228 Ne Jefferson Ave, Peoria, Illinois. To know further, please read the information below!

Provider Profile Detail

Provider Name George Kenneth Shotick
Address 228 Ne Jefferson Ave, Peoria, Illinois
Phone Number 3096718000
Fax Number 3096714695
Sole Proprietor N
Credentials M.D.

NPI Number Detail

NPI Number 1104941657
Provider Enumeration Date 2007-03-20
Last Updated Date 2016-02-15

Provider Mailing Address Detail

Address 228 Ne Jefferson Ave
City Peoria
State Illinois (IL)
Post Code 616033802
Phone Number 3096718000
Fax Number 3096714695

Provider's Primary Taxonomy Detail

Speciality Family Medicine
Taxonomy 207Q00000X
Licence No 036-059533
Definition:
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i

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FAQs about George Kenneth Shotick

What is the unique identifier code issued to George Kenneth Shotick by the Centers for Medicare & Medicaid Services?

The George Kenneth Shotick has been assigned the NPI (National Provider Identifier) 1104941657. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).

Could you please share the complete physical address where George Kenneth Shotick is geographically located?

The George Kenneth Shotick is physically situated at the following location: 228 Ne Jefferson Ave, Peoria, IL, 616033802.

What is the area of specialization for George Kenneth Shotick, and what is the corresponding taxonomy classification code for this field?

The specialized field of practice for George Kenneth Shotick is Family Medicine, and the corresponding taxonomy code that categorizes this area of expertise is 207Q00000X.

On what date did the Centers for Medicare & Medicaid Services originally issue the 1104941657 to George Kenneth Shotick?

The Centers for Medicare & Medicaid Services originally issued the 1104941657 to George Kenneth Shotick on 2007-03-20.

When was the information regarding George Kenneth Shotick, such as address, specialty, and other details, most recently verified or confirmed to be accurate?

The information pertaining to George Kenneth Shotick, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2016-02-15.

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