Organization
CHITTICK SCC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN MALLADY (FACILITY DIRECTOR)
(217) 398-2020
Entity
Organization
Contact information
Practice address
501 N DUNLAP AVE, SAVOY, IL 61874-8403
(217) 398-2020
Mailing address
1104 N VERMILION ST, DANVILLE, IL 61832-3094
(217) 398-2020
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
Other
Enumeration date
01/17/2025
Last updated
02/07/2025
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