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Individual
SHANE RAFFERTY
Active
Individual
SHANE RAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CCLS
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
21312
IL
Other
Enumeration date
12/10/2019
Last updated
06/03/2020
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