Beaty, Shad
Beaty, Shad is an individual health care provider with primary practice located at 2005 Jacobssen Dr , Normal IL 61761-6287. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Beaty, Shad can be contacted via phone (309) 319-7360.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-106215 | Illinois |
Profile Details
| NPI number | 1538241591 |
|---|---|
| LBN Legal business name | Beaty, Shad |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2006 |
| Last updated | Oct 3rd, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538241591 | NPPES |
| Illinois | MEDICAID | 036106215 |
Popular Providers
-
Cappitelli, Dennis W
College And University 2540 , Normal IL 61790-2540 -
Houston, Mariyam Yasmeen
1300 Franklin Ave Ste 110 , Normal IL 61761-3799 -
Ebreo, Adam
1302 Franklin Ave Suite 1100, Normal IL 61761-3551 -
Lundy, Molly
2005 Jacobssen Dr , Normal IL 61761-6287 -
Sharma, Amit
1304 Franklin Ave , Normal IL 61761-3558 -
Jewell-Mahler, Victoria
1600 Coraopolis Heights Rd Ste E, Moon Twp PA 15108-4316 -
Sayat, Jonathan G
555 S Floyd St , Louisville KY 40202-3822 -
Tillman, Anita M.
1302 Franklin Ave Suite 2500, Normal IL 61761-3551