Burke, Shane Patrick
Burke, Shane Patrick is an sole proprietor health care provider with primary practice located at 221 Ne Glen Oak Ave , Peoria IL 61636-0001. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Burke, Shane Patrick can be contacted via phone (309) 495-1640.Contact Information
Primary practice address
221 Ne Glen Oak Ave
Peoria IL 61636-0001
Phone: (309) 495-1640
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 0.36.150948 | Illinois |
Profile Details
| NPI number | 1568996320 |
|---|---|
| LBN Legal business name | Burke, Shane Patrick |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 18th, 2017 |
| Last updated | Sep 1st, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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