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Organization
PRIMARY CARE PHYSICIANS, S.C.
Active
Organization
PRIMARY CARE PHYSICIANS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY WILLIAM SHAW D.C. (OWNER/PRESIDENT)
(217) 224-3935
Entity
Organization
Contact information
Practice address
3701 E LAKE CTR, SUITE 1, QUINCY, IL 62305-5842
(217) 224-3935
Mailing address
3701 E LAKE CTR, SUITE 1, QUINCY, IL 62305-5842
(217) 224-3935
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
207R00000X
Internal Medicine Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123650
BCBS GROUP NUMBER
IL
Enumeration date
07/25/2006
Last updated
03/10/2008
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