SHANE RAFFERTY (NPI# 1720625601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720625601 |
| Entity Type | Individual |
| Full Name | SHANE RAFFERTY |
| Credential | MS, CCLS |
| Practice Address |
4852 N Rockwell St Apt 2 Chicago IL 60625-6521 |
| Practice Telephone | 8472191824 |
| Mailing Telephone | 8472191824 |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2020-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
21312 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
4852 N ROCKWELL ST APT 2 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60625-6521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726615 | B Wise Rehabilitation Pllc | Physical Therapist | 4754 N Lincoln Ave, Fl 1, Chicago, IL 60625 | 2020-10-07 |
| 1700490448 | Anita Saini | Pharmacist | 5140 N California Ave, Chicago, Il 60625, Chicago, IL 60625 | 2020-09-01 |
| 1699303164 | Marina Karamanis | Student in an Organized Health Care Education/Training Program | Swedish Hospital, 5140 N. California Ave, Chicago, IL 60625 | 2020-03-31 |
| 1063050227 | Jacqueline Guadalupe Saldana | Behavioral Analyst | 8616 W Catalpa Ave, Suite 1106, Chicago, IL 60625 | 2019-12-18 |
| 1912557802 | Six Senses Therapy LLC | Social Worker | 2334 W. Lawrence Avenue, Suite 204c, Chicago, IL 60625 | 2019-09-13 |
| 1982266110 | Noreen Randhawa | Family Medicine | Swedish Hospital Part of North Shore, 5145 N. California Ave., Chicago, IL 60625 | 2019-07-09 |
| 1376102202 | Nita Gupta | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Department, 5145 N. California Ave, Chicago, IL 60625 | 2019-06-13 |
| 1841763471 | Alexandra Taskier | Counselor | 5359 N Bowmanville Ave., Chicago, IL 60625 | 2019-01-07 |
| 1013490143 | Paula Bielnicka | Pharmacist | Swedish Covenant Hospital - Pharmacy, 5140 N California Ave, Chicago, IL 60625 | 2018-09-14 |
| 1902397078 | Rebecca Abraham | Hospitalist | 5145 N California Ave Ofc M331, Chicago, IL 60625 | 2018-05-24 |
| Find all providers in zip 60625 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376930750 | Prudence Hartwell | Pediatrics | 5841 S Maryland Ave # Mc0900, Chicago, IL 60637 | 2015-04-23 |
| 1942598891 | Sotiria E. Moschovis | Pediatrics | 6127 N. Leader Ave., Chicago, IL 60646 | 2011-07-13 |
| 1720142995 | Peter Joseph Smith Sr. | Pediatrics | 950 E. 61st Street, Ssc, Suite 207, Chicago, IL 60637 | 2006-12-21 |
| 1134644834 | Shevia Morris | Pediatrics | 5116 N Nordica Ave, Chicago, IL 60656-3606 | 2017-08-03 |
| 1982066957 | Maria Gabriela Balsa Guerrero | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2016-03-28 |
| 1922484823 | Tanuja Kothinti | Pediatrics | 5841 S Maryland Ave, Chicago, IL 60637 | 2015-08-03 |
| 1831516962 | Charron Mckenzie Lewis | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637 | 2014-03-26 |
| 1174790745 | Sarah Courtney Bauer | Pediatrics | 225 E Chicago Ave, Box 2, Chicago, IL 60611-2605 | 2008-05-13 |
| 1194990705 | Karin Elizabeth Vander Ploeg Booth | Pediatrics | 950 E 61st St, Section of Dbp Ssc Room 207, Chicago, IL 60637-2623 | 2008-04-24 |
| 1659421691 | Lawrence A Gray | Pediatrics | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2007-01-11 |
| 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.