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NPI Code Detail

MEDICARE: COREY ANDREW SHREWSBERRY

MEDICARE:   COREY ANDREW SHREWSBERRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209027901IL
2363LF0000XFamily Nurse Practitioner209027901IL

General Provider Information

NPI Number : 1619738697
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY ANDREW SHREWSBERRY
Provider Business Mailing Address
First Line : 1901 BUTTERFIELD RD STE 800
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-7921
Country : US
Telephone Number : 888-987-1597
Fax Number :
Provider Business Practice Location Address
First Line : 418 E MAIN STREET RD
Second Line :
City : CARY
State : IL
Zip : 60013-2990
Country : US
Telephone Number : 815-353-7434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2024
Last Update Date : 01/22/2024

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Directions to “ COREY ANDREW SHREWSBERRY ” Practice Location

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