Individual ProviderSamuel ShoversSocial WorkerBehavioral Health & Social Service ProvidersPractice Address2400 N Ashland Ave, Chicago, IL 60614-2021(773) 904-2597PECOS EnrollmentBased on the most recent information from CMS, provider Samuel Shovers is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1235892068Provider TypeIndividualFull NameShovers, SamuelCredentialLSWGenderMaleSole ProprietorNoEnumeration Date10/19/2021Last Updated2/6/2022Contact InformationPractice LocationPractice Address2400 N Ashland Ave, Chicago, IL 60614-2021Phone(773) 904-2597FaxUnlisted FaxMailing LocationMailing Address1552 W Fullerton Ave # 100, Chicago, IL 60614-9018PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense150.105367Illinois