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General NPI Number Information
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NPI Number | 1609736099
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Entity Type | Individual
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Provider Name | MS. SHAKEETA ROCKELL ARCHER
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Gender | Female
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1614 E 53RD ST STE 5
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City | CHICAGO
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State | IL
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Zip | 60615-4210
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Country | US
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Telephone | 708-567-4560
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Fax |
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Provider Business Mailing Address
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Address Line | 1614 E 53RD ST STE 5
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City | CHICAGO
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State | IL
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Zip | 60615-4210
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Country | US
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Telephone | 708-567-4560
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | JOB0C88WIM
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License Number State | IL
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