Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209009601 | IL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 71003309 | IN |
NPI | 1548567357 |
---|---|
Provider Name | Mrs. Morgan Lyndsey Wininger Shanks |
First Address | Downers Grove, IL 60515 |
Second Address | Downers Grove, IL 60515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2011 |
Last Update Date | 08/11/2013 |