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General NPI Number Information
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NPI Number | 1629828728
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Entity Type | Individual
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Provider Name | HEATHER SHAY WEST APRN
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Gender | Female
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 2525 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60616-2315
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Country | US
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Telephone | 312-702-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 1752 W CATALPA AVE # 1W
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City | CHICAGO
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State | IL
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Zip | 60640-1106
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Country | US
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Telephone | 702-722-8886
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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 | 209029248
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License Number State | IL
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