Provider Demographics
NPI:1972017291
Name:SITKO, SHAY ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAY
Middle Name:ELIZABETH
Last Name:SITKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 CHATHAM RD STE A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-7004
Mailing Address - Country:US
Mailing Address - Phone:217-698-5800
Mailing Address - Fax:
Practice Address - Street 1:2920 CHATHAM RD STE A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-7004
Practice Address - Country:US
Practice Address - Phone:217-698-5800
Practice Address - Fax:217-698-4863
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.00007634111N00000X
IL038013431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor