Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 209.008687041.250937 | IL |
NPI | 1023399185 |
---|---|
Provider Name | Robin Shinall |
First Address | Western Springs, IL 60558-1806 |
Second Address | Glenview, IL 60025-7645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2011 |
Last Update Date | 02/09/2011 |