DR. SHANICKA N SCARBROUGH (NPI# 1639307895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639307895 |
| Entity Type | Individual |
| Full Name | DR. SHANICKA N SCARBROUGH |
| Other Name | DR. SHANICKA N WILLIAMS |
| Credential | M.D. |
| Practice Address |
4753 N Broadway St Ste 514 Chicago IL 60640 |
| Mailing Address |
Po Box 221788 Sacramento CA 95822-8788 |
| Practice Telephone | 8668348463 |
| Practice Fax Number | 8668348463 |
| Mailing Telephone | 3127222683 |
| Mailing Fax Number | 3122757549 |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2018-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036.128645 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036128645 | 05 |
| Street Address |
4753 N BROADWAY ST STE 514 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578560736 | Roberta Sue Barry | Social Worker | 4753 N Broadway St, Suite 928, Chicago, IL 60640-5266 | 2005-07-02 |
| 1538667084 | Kenan Pojskic | Clinic/Center | 4753 N Broadway St, Chicago, IL 60640-5266 | 2018-01-30 |
| 1033617865 | Kamran Naseem Malik | Clinic/Center | 4753 N Broadway St, Chicago, IL 60640-5266 | 2018-01-26 |
| 1912405895 | Hrishikesh T Shetty | Clinic/Center | 4753 N Broadway St, Chicago, IL 60640-5266 | 2018-01-25 |
| 1639614209 | Joanne Kardell | Social Worker | 4753 N Broadway St, 826, Chicago, IL 60640-5266 | 2017-01-05 |
| 1376997379 | Sachiko Kawata | Social Worker | 4753 N Broadway St, Suite #925, Chicago, IL 60640-5266 | 2016-04-16 |
| 1619321692 | Jennifer Annen | Counselor | 4753 N Broadway St, Suite 826, Chicago, IL 60640-5266 | 2016-04-15 |
| 1619355542 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 4753 N Broadway St, Suite 612, Chicago, IL 60640-5266 | 2015-05-12 |
| 1225434236 | Joanna Vergoth | Social Worker | 4753 N Broadway St, Suite 509, Chicago, IL 60640-5266 | 2014-11-18 |
| 1548662257 | Daniel N Danforth | Acupuncturist | 4753 N Broadway St, Ste 810, Chicago, IL 60640-5266 | 2014-09-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.