| Nicholas Shea Pc | |
|
2045 W Grand Ave Ste B Pmb 82557 Chicago IL 60612-1577 | |
| (312) 268-4070 | |
| (312) 277-1042 |
| Full Name | Nicholas Shea Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2045 W Grand Ave Ste B, Chicago, Illinois |
| Authorized Official Name and Position | Nicholas Joseph Shea (OWNER, NICHOLAS SHEA, PC & PROVIDER) |
| Authorized Official Contact | 3122684070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas Shea Pc 180 N Michigan Ave Suite 350 Chicago IL 60601-7401 Ph: (312) 268-4070 | Nicholas Shea Pc 2045 W Grand Ave Ste B Pmb 82557 Chicago IL 60612-1577 Ph: (312) 268-4070 |
| NPI Number | 1285984047 |
|---|---|
| Provider Enumeration Date | 09/19/2012 |
| Last Update Date | 04/13/2021 |
| Certification Date | 04/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285984047 | NPI | - | NPPES |
| 1942457882 | Other | IL | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036123263 (Illinois) | Primary |
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