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NPI Code Detail

MEDICARE: SHELBY HELMICK

MEDICARE:   SHELBY  HELMICK
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
1363LF0000XFamily Nurse Practitioner209029917IL

General Provider Information

NPI Number : 1548004658
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY HELMICK
Provider Business Mailing Address
First Line : 5409 N KNOXVILLE AVE
Second Line :
City : PEORIA
State : IL
Zip : 61614-5069
Country : US
Telephone Number : 309-691-1069
Fax Number :
Provider Business Practice Location Address
First Line : 5901 N KNOXVILLE AVE
Second Line :
City : PEORIA
State : IL
Zip : 61614-4357
Country : US
Telephone Number : 309-691-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2024
Last Update Date : 11/29/2024

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Directions to “ SHELBY HELMICK ” Practice Location

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