SHANE RAFFERTY MS, CCLS
NPI 1720625601
Pediatrics - Developmental - Behavioral Pediatrics in Chicago, IL

Q: What is Shane Rafferty's NPI number?

The NPI number for Shane Rafferty is 1720625601. It was assigned to this individual provider in the NPPES registry on December 10, 2019.

Q: What is Shane Rafferty's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Q: When was this NPI record last updated?

The NPPES record for Shane Rafferty was last updated on June 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 10, 2019

4852 N ROCKWELL ST APT 2, CHICAGO, IL 60625(847) 219-1824 Get Directions Write a Review

NPPES record last updated: June 3, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 3, 2020, Dec 10, 2019 (2 updates tracked since 2019).

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About Shane Rafferty Ms, Ccls NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE RAFFERTY MS, CCLS (NPI 1720625601) is an individual developmental - behavioral pediatrics provider in Chicago, Illinois, licensed in Illinois (21312) and active in the NPI registry since December 2019.

NPPES Registry Identity

NPI1720625601

Entity TypeIndividualMale

Primary Taxonomy2080P0006X

Provider Legal NameSHANE RAFFERTYCredential: MS, CCLS

Location Address4852 N ROCKWELL ST APT 2Chicago, IL 60625-6521

Mailing Address4852 N Rockwell St Apt 2Chicago, IL 60625-6521 · (847) 219-1824

Phone(847) 219-1824

Sole ProprietorNo

Enumeration DateDecember 10, 2019

Last NPPES UpdateJune 3, 20202 updates tracked since enumeration

NPPES CertifiedJune 3, 2020

✔ NPI 1720625601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians

Taxonomy Code2080P0006X

License✔ Licensed in IL · 21312

Definition

A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.

4852 N ROCKWELL ST APT 2, Chicago, IL 60625

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Rafferty's NPI number?

The NPI number for Shane Rafferty is 1720625601. It was assigned to this individual provider in the NPPES registry on December 10, 2019.

Where is Shane Rafferty located?

Shane Rafferty practices at 4852 N Rockwell St Apt 2, Chicago, IL 60625. The listed phone number is (847) 219-1824.

What is Shane Rafferty's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

When was this NPI record last updated?

The NPPES record for Shane Rafferty was last updated on June 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.