Healthcare Provider Details

I. General information

NPI: 1558357384
Provider Name (Legal Business Name): DOROTHY SHAPIRO APN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BIESTERFIELD RD SUITE 510
ELK GROVE VILLAGE IL
60007-3311
US

IV. Provider business mailing address

800 BIESTERFIELD RD SUITE 510
ELK GROVE VILLAGE IL
60007-3361
US

V. Phone/Fax

Practice location:
  • Phone: 847-981-3660
  • Fax: 847-956-5108
Mailing address:
  • Phone: 847-981-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209-002891
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: