Organization
R. DENNIS SHELBY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DENNIS SHELBY MSW, PHD (SOLE PROPRIETOR)
(312) 458-9214
Entity
Organization
Contact information
Practice address
348 E 1325 N, CHESTERTON, IN 46304-9540
(312) 458-9214
Mailing address
180 N MICHIGAN AVE, 2413, CHICAGO, IL 60601-7401
(312) 458-9214
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149002949
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01671068
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/06/2007
Last updated
06/24/2008
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