Shad Beaty is a Pediatrics in Normal, Illinois. Shad Beaty practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Shad Beaty is 1538241591. The last update date is 2022-10-03.
Shad Beaty's current location address is 2005 Jacobssen Dr, Normal, Illinois. You can contact this provider via phone number 3093197360. The mailing address for Shad Beaty is 2005 Jacobssen Dr, Normal, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shad Beaty |
|---|---|
| Address | 2005 Jacobssen Dr, Normal, Illinois |
| Phone Number | 3093197360 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1538241591 |
|---|---|
| Provider Enumeration Date | 2006-10-19 |
| Last Updated Date | 2022-10-03 |
Provider Mailing Address Detail
| Address | 2005 Jacobssen Dr |
|---|---|
| City | Normal |
| State | Illinois (IL) |
| Post Code | 617616287 |
| Phone Number | 3093197360 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | 036-106215 |
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Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36106215 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Shad Beaty by the Centers for Medicare & Medicaid Services?
The Shad Beaty has been assigned the NPI (National Provider Identifier) 1538241591 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Shad Beaty is physically located?
The Shad Beaty is physically situated at the following address: 2005 Jacobssen Dr, Normal, IL, 617616287.
What is Shad Beaty's area of expertise and its corresponding taxonomy classification?
The Shad Beaty's field of specialization is Pediatrics, and it falls under the taxonomy code 208000000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Shad Beaty receive its 1538241591 assignment from the Centers for Medicare & Medicaid Services?
The Shad Beaty was assigned its 1538241591 by the Centers for Medicare & Medicaid Services on 2006-10-19.
As of what date was the information pertaining to Shad Beaty, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Shad Beaty, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2022-10-03.