Healthcare Provider Details

I. General information

NPI: 1336876531
Provider Name (Legal Business Name): GARDENIA SHAMOUN DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GARDENIA ZOZAN DNP

II. Dates (important events)

Enumeration Date: 08/07/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

IV. Provider business mailing address

1610 KINGSDALE RD
HOFFMAN ESTATES IL
60169-4039
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-1000
  • Fax:
Mailing address:
  • Phone: 217-218-0727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209.036168
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: