Dr. Shelly Mann
Adolescent Medicine
1170 E Belvedere Rd #106
Grayslake
, Illinois 60030
Dr. Shelly Mann
Adolescent Medicine
1170 E Belvedere Rd #106
Grayslake
, Illinois 60030
(847) 548-9909
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Dr. Shelly Mann
- 1170 E Belvedere Rd #106
- Grayslake, IL
- Zip : 60030
- Fax : (847) 548-9909
- Phone : (847) 548-7337
Second Address
- Dr. Shelly Mann
- 1170 E Belvedere Rd #106
- Grayslake, IL
- Zip : 60030
- Fax : (847) 548-9909
- Phone : (847) 548-7337
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 036106369 | IL |
National Provider Identifier
| NPI | 1194719211 |
|---|---|
| Provider Name | Dr. Shelly Mann |
| First Address | Grayslake, IL 60030 |
| Second Address | Grayslake, IL 60030 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/09/2005 |
| Last Update Date | 27/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 006726984 | (05) | VA |
| 036106369 | (05) | IL |
| F69665 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.