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:
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Health care specialties

SpecialtyCodeLicense #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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