Shallat, Shelly
Shallat, Shelly is an individual health care provider with primary practice located at 10 Saint Clare Ct , Washington IL 61571-9239. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Shallat, Shelly can be contacted via phone (309) 886-4000.Contact Information
Primary practice address
10 Saint Clare Ct
Washington IL 61571-9239
Phone: (309) 886-4000
Fax: (309) 886-4118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-101025 | Illinois |
Profile Details
| NPI number | 1184706988 |
|---|---|
| LBN Legal business name | Shallat, Shelly |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Nov 11th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184706988 | NPPES |
| Illinois | MEDICAID | 036101025 | |
| Illinois | Other | 07223454 | |
| Illinois | Other | IL20810 |
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