| R. Dennis Shelby | |
|
348 E 1325 N Chesterton IN 46304-9540 | |
| (312) 458-9214 | |
| Not Available |
| Full Name | R. Dennis Shelby |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 348 E 1325 N, Chesterton, Indiana |
| Authorized Official Name and Position | Robert Dennis Shelby (SOLE PROPRIETOR) |
| Authorized Official Contact | 3124589214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R. Dennis Shelby 180 N Michigan Ave 2413 Chicago IL 60601-7401 Ph: (312) 458-9214 | R. Dennis Shelby 348 E 1325 N Chesterton IN 46304-9540 Ph: (312) 458-9214 |
| NPI Number | 1295938546 |
|---|---|
| Provider Enumeration Date | 06/06/2007 |
| Last Update Date | 06/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295938546 | NPI | - | NPPES |
| 01671068 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149002949 (Illinois) | Primary |
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