DR. GEORGE KENNETH JR. SHOTICK (M.D.) – Family Medicine Physician, NPI 1104941657

DR. GEORGE KENNETH JR. SHOTICK (M.D.) is a healthcare provider. based in Peoria, Illinois. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 036-059533 (IL). The NPI Number for DR. GEORGE KENNETH JR. SHOTICK (M.D.) is 1104941657

Main info

Male
48 Years Of Experience
Accepts Medicare Assignment
Name
DR. GEORGE KENNETH JR. SHOTICK (M.D.)
NPI
1104941657
Phone
(309) 671-8000
Address
228 NE JEFFERSON AVE
Enumeration Date
20 March 2007
Last Update Date
15 February 2016

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3096718005
Graduation Year
1978 (48 years ago)
PAC ID
5395913446
Group Practice PAC ID
6901896968
Professional Enrollment ID
I20110718000115
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for DR. GEORGE KENNETH JR. SHOTICK (M.D.)

  • 228 NE JEFFERSON AVE

    PEORIA, IL 616033802

    Phone: (309) 671-8000

    Fax: (309) 671-4695

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61603)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6901896968View full group profile

Reviews

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Frequently asked questions

What is DR. GEORGE KENNETH JR. SHOTICK (M.D.)'s NPI number?
DR. GEORGE KENNETH JR. SHOTICK (M.D.)'s NPI is 1104941657 — the number used across U.S. healthcare to identify this provider.
Would DR. GEORGE KENNETH JR. SHOTICK (M.D.) appear as active to a payer?
You can treat DR. GEORGE KENNETH JR. SHOTICK (M.D.) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. GEORGE KENNETH JR. SHOTICK (M.D.)?
DR. GEORGE KENNETH JR. SHOTICK (M.D.)'s specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Illinois is DR. GEORGE KENNETH JR. SHOTICK (M.D.) registered?
Use Peoria, Illinois as the headline location for DR. GEORGE KENNETH JR. SHOTICK (M.D.) here.
Does DR. GEORGE KENNETH JR. SHOTICK (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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