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

Shane Rafferty, MS, CCLS

Individual provider Developmental - Behavioral Pediatrics Physician · NPI 1720625601

Shane Rafferty, MS, CCLS is a Developmental - Behavioral Pediatrics Physician in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2019.

Licensed in
IL
In the registry since
2019
What do these letters mean?
MS — Master of Science
A graduate science degree.

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Practice location Address checks out

4852 N Rockwell St Apt 2
Chicago, IL 60625-6521
Phone: (847) 219-1824
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmental - Behavioral Pediatrics Physician (primary) Taxonomy 2080P0006X · Licence 21312 (IL)

Record details

NPI number1720625601
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , CCLS
Sole proprietorNo
NPI enumeratedDecember 10, 2019
Last updated in NPPESJune 3, 2020
Certification dateJune 3, 2020
Mailing address4852 N Rockwell St Apt 2, Chicago, IL 60625-6521

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