Individual
SCOTT SHADRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3665 N BROADWAY ST, CHICAGO, IL 60613-4567
(773) 496-4433
Mailing address
705 W BROMPTON AVE APT 24, CHICAGO, IL 60657-1821
(224) 545-7983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.009602
IL
Other
Enumeration date
01/06/2022
Last updated
08/30/2023
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