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General NPI Number Information
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NPI Number | 1386215309
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Entity Type | Individual
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Provider Name | SHIRLEY SCOTT WHNP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 05/12/2024
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Provider Practice Location Address
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Address Line | 840 S WOOD ST # MC718
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City | CHICAGO
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State | IL
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Zip | 60612-4325
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Country | US
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Telephone | 224-650-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 840 S WOOD ST # MC718
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City | CHICAGO
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State | IL
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Zip | 60612-4325
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.023734
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041283655
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 041283655
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License Number State | IL
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