Organization
NICHOLAS SHEA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS JOSEPH SHEA MD (OWNER, NICHOLAS SHEA, PC & PROVIDER)
(312) 268-4070
Entity
Organization
Contact information
Practice address
2045 W GRAND AVE STE B, PMB 82557, CHICAGO, IL 60612-1577
(312) 268-4070
(312) 277-1042
Mailing address
180 N MICHIGAN AVE, SUITE 350, CHICAGO, IL 60601-7401
(312) 268-4070
(312) 423-6695
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036123263
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942457882
INDIVIDUAL NPI NUMBER
IL
Enumeration date
09/19/2012
Last updated
04/13/2021
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