Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shad Beaty

Individual provider Pediatrics Physician · NPI 1538241591

Shad Beaty is a Pediatric Medicine in Normal, Illinois. Qualified in 1999, 27 years ago. Practices with Springfield Clinic, LLP, a 679-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
27
Licensed in
IL
In the registry since
2006

Practice location Address checks out

2005 Jacobssen Dr
Normal, IL 61761-6287
Phone: (309) 319-7360
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 036-106215 (IL)

Record details

NPI number1538241591
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 19, 2006
Last updated in NPPESOctober 3, 2022
Certification dateOctober 3, 2022
Mailing addressPo Box 19248, Springfield, IL 62794-9248

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Springfield Clinic, Llp — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Normal