Healthcare Provider Details

I. General information

NPI: 1538063243
Provider Name (Legal Business Name): SHIRLEY CHILES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11801 UNION AVE
CLEVELAND OH
44105-1945
US

IV. Provider business mailing address

11801 UNION AVE
CLEVELAND OH
44105-1945
US

V. Phone/Fax

Practice location:
  • Phone: 216-389-1893
  • Fax:
Mailing address:
  • Phone: 216-389-1893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: