Individual
MR. COREY WENDELL SHUMATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN, PMHNP-BC
Contact information
Practice address
2701 W 68TH ST, CHICAGO, IL 60629
(773) 884-9000
Mailing address
2701 W 68TH ST, CHICAGO, IL 60629-1882
(773) 884-7640
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.016033
IL
Other
Enumeration date
09/07/2017
Last updated
07/09/2018
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