Shad Beaty
Pediatrics | Male
Shad Beaty is a Springfield, Illinois based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Shad Beaty is
Po Box 19248, Springfield, Illinois - 62794-9248. He can be contacted on phone at
217-528-7541.
Shad Beaty is a sole proprietor of his business.
NPI number (Unique professional ID) for Shad Beaty is
1538241591 which was assigned by NPPES on 19 Oct, 2006 and it was last updated on 03 Oct, 2022.
Shad Beaty license number is
036-106215 for Pediatrics (208000000X) in Illinois.
Shad Beaty is a pediatrician who 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 chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Shad Beaty basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Shad Beaty |
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| Gender : | Male |
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Business Address:
Shad Beaty address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | Po Box 19248
Springfield, IL, 62794-9248
United States |
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| Phone Number : | 217-528-7541 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1538241591 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 19 Oct, 2006 |
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| Last Updated On : | 03 Oct, 2022 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Shad Beaty are as mentioned. Primary taxonomy code for Shad Beaty is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 036-106215 | IL |
Legacy Identifiers:
Other legacy medical identifiers of Shad Beaty such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 036106215 | MEDICAID | IL | |
| 370021626 / CA4079 | MEDICARE ID-Type Unspecified | IL | RR |
| 809840 | MEDICARE ID-Type Unspecified | IL | Group # |
| H68028 | MEDICARE UPIN | | |
| L92937 | MEDICARE ID-Type Unspecified | IL | Individual # |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2005 Jacobssen Dr
Normal, IL, 61761-6287
United States |
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| Phone Number : | 309-319-7360 |
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Business Location:
Patients can refer following map for directions to
Shad Beaty practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.