Shallow, Charlene
Shallow, Charlene is an individual health care provider with primary practice located at 747 N Rutledge St Fl 4 , Springfield IL 62702-6700. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Shallow, Charlene can be contacted via phone (217) 545-8000.Contact Information
Primary practice address
747 N Rutledge St Fl 4
Springfield IL 62702-6700
Phone: (217) 545-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 277.001220 | Illinois |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 209.005660 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 209005660 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 277.001220 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 209-005660 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 277.001220 | Illinois |
Profile Details
| NPI number | 1295819688 |
|---|---|
| LBN Legal business name | Shallow, Charlene |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Feb 3rd, 2022 - about 2 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.
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