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NPI Code Detail

MEDICARE: RACHAEL MARIE SHAHWAN

MEDICARE: RACHAEL MARIE SHAHWAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209034014IL
2163WI0500XInfusion Therapy Registered Nurse041474956IL

General Provider Information

NPI Number : 1245104157
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL MARIE SHAHWAN
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number : 847-390-4757
Provider Business Practice Location Address
First Line : 1221 N HIGHLAND AVE
Second Line :
City : AURORA
State : IL
Zip : 60506-1404
Country : US
Telephone Number : 630-264-8580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2025
Last Update Date : 12/12/2025

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