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NPI Code Detail

MEDICARE: LEON SHAW

MEDICARE: LEON SHAW
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
1101YP1600XPastoral CounselorIL

General Provider Information

NPI Number : 1639062508
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEON SHAW
Provider Business Mailing Address
First Line : 1755 PARK ST STE 200
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-8404
Country : US
Telephone Number : 815-260-6051
Fax Number :
Provider Business Practice Location Address
First Line : 1755 PARK ST STE 200
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-8404
Country : US
Telephone Number : 815-260-6051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2025
Last Update Date : 12/13/2025

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Directions to “ LEON SHAW ” Practice Location

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