Individual
DR. LAURA MCGARRY SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
6323 N AVONDALE AVE STE 103, CHICAGO, IL 60631-1962
(847) 993-7423
(847) 993-7420
Mailing address
6323 N AVONDALE AVE STE 103, CHICAGO, IL 60631-1962
(847) 993-7423
(847) 993-7420
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005081
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005081
—
IL
01
—
0707390001
DMERC
IL
01
—
60001380
BCBC OF ILLINOIS
IL
01
—
726711
MEDICARE PROVIDER #
IL
01
—
CE8840
MEDICARE RR GROUP #
IL
01
—
P00419869
MEDICARE RR PTAN #
IL
Enumeration date
08/03/2006
Last updated
03/28/2019
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