Healthcare Provider Details

I. General information

NPI: 1619738697
Provider Name (Legal Business Name): COREY A SHREWSBERRY NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BARRINGTON COMMONS CT 1790
BARRINGTON IL
60011
US

IV. Provider business mailing address

106 BARRINGTON COMMONS CT 1790
BARRINGTON IL
60011
US

V. Phone/Fax

Practice location:
  • Phone: 847-719-2220
  • Fax: 847-719-2265
Mailing address:
  • Phone: 847-719-2220
  • Fax: 847-719-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209027901
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209027901
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: