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General NPI Number Information
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NPI Number | 1568260552
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Entity Type | Individual
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Provider Name | SHAVOUYA TERRY
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Gender | Female
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 5113 S HARPER AVE # 2031A
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City | CHICAGO
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State | IL
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Zip | 60615-4119
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Country | US
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Telephone | 872-314-1368
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Fax | 872-871-5984
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Provider Business Mailing Address
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Address Line | 5113 S HARPER AVE # 2031A
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City | CHICAGO
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State | IL
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Zip | 60615-4119
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Country | US
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Telephone | 872-314-1368
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Fax | 872-871-5984
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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