Individual provider · Type 1 NPI
Stacey A. Shaw
Pediatric Nurse Practitioner · Chicago, IL
NPI number
1356973762
Active
Practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Mailing address
150 Harvester Dr, Suite 300
Burr Ridge, IL 60527-5919
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 209019812 (IL) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1356973762
Stacey A. Shaw's National Provider Identifier is 1356973762, issued on Feb 4, 2020. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Chicago, IL. The record was last updated on Oct 24, 2022.