KATHLEEN M SHAW (NPI# 1326149162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326149162 |
| Entity Type | Individual |
| Full Name | KATHLEEN M SHAW |
| Other Name | KATHLEEN M PESTRELLA |
| Credential | M.D. |
| Practice Address |
3315 N Seminary St Galesburg IL 61401-1251 |
| Practice Telephone | 3093441000 |
| Practice Fax Number | 3093441054 |
| Mailing Telephone | 3093441000 |
| Mailing Fax Number | 3093441054 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BC/BS | 4815127 | 01 | |
| CAQH | 10613852 | 01 | |
| AETNA | 4003365 | 01 | |
| JOHN DEERE | 364271985-25 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134477573 | Kathleen Connie Shaw | Social Worker | 34367 Virgil St, Harrison Twp, MI 48045-3387 | 2012-08-15 |
| 1962781484 | Kathleen Sarah Shaw | Physical Therapist | 142 East Beaver Creek Bld, Unit 109, Avon, CO 81620 | 2011-08-15 |
| 1033302849 | Kathleen Anne Shaw | Massage Therapist | 7866 W Sample Rd, Margate, FL 33065-4710 | 2007-08-24 |
| 1598223810 | Kathleen Shaw | Behavior Technician | 39420 Liberty St Ste 150, Fremont, CA 94538-2284 | 2019-03-05 |
| 1417459835 | Kathleen Gem Shaw | Clinical Neuropsychologist | 650 Pennsylvania Ave Se, Washington, DC 20003-4318 | 2018-03-01 |
| 1477080927 | Kathleen Marie Shaw | Counselor | 611 W Admiral Doyle Dr, New Iberia, LA 70560-6408 | 2017-05-15 |
| 1386040566 | Kathleen Shaw | Skilled Nursing Facility | 795 Washington Rd, Rye, NH 03870-2318 | 2014-11-14 |
| 1164609640 | Kathleen Mary Shaw | Social Worker | 320 Main St, West Newbury, MA 01985-1420 | 2008-01-27 |
| Street Address |
3315 N SEMINARY ST |
| City | GALESBURG |
| State | IL |
| Zip Code | 61401-1251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487696126 | Noor A Khaiser | Internal Medicine | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2006-06-10 |
| 1669022752 | Angela M Bickett | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-09-19 |
| 1902455140 | Bailey Jean Bucher | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-09-10 |
| 1417509407 | Tara Lynn Livingston | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-07-10 |
| 1164984225 | Julie Anne Maner-stevenson | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-04-05 |
| 1629573878 | Brittany S Simmons | Physician Assistant | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2018-03-29 |
| 1508360066 | Angela B Klapp | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2018-03-20 |
| 1962831511 | Amanda Ryan | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2013-11-04 |
| 1922436682 | Jackie Spence | Physician Assistant | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2013-10-16 |
| 1003164617 | Melissa Hajostek | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2012-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174973 | Jeff Engwall | Pharmacist | 359 Knox Square Drive, Galesburg, IL 61401 | 2020-11-03 |
| 1861962441 | Becky Cameron | Counselor | 2323 Windish Dr., Galesburg, IL 61401 | 2018-11-27 |
| 1295245496 | Aaron Thomas Wachtel | Dentist | 1172 Monroe Street, Galesburg, IL 61401 | 2017-10-03 |
| 1588182224 | Alicia Warren | Speech-Language Pathologist | 932 Harrison St., Galesburg, IL 61401 | 2017-09-01 |
| 1770986770 | Virginia G Kasser | Psychologist | 575 N Kellogg, Galesburg, IL 61401 | 2014-10-03 |
| 1063814309 | Lakshmi Kalyani Gudavalli | Physical Therapist | 275 E Carl Sandburg Drive, Marigold Rehabilitation, Galesburg, IL 61401 | 2014-09-18 |
| 1821350489 | James Eugene Tiller | Psychologist | 2101 Windish Drive, Galesburg, IL 61401 | 2012-06-11 |
| 1720285836 | Donald J. Regnier | Hearing Instrument Specialist | 4l Plaza, Suite 57, Galesburg, IL 61401 | 2007-07-02 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114140373 | Community Residential Centers Inc | Intermediate Care Facility, Mentally Retarded | 239 S Cherry Street, Galesburg, IL 61401 | 2007-04-10 |
| Find all providers in zip 61401 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972522712 | Jeffrey A. Baumgardner | Obstetrics & Gynecology | 940 N Henderson St, Galesburg, IL 61401-2520 | 2006-07-19 |
| 1225290083 | Lorraine Ann Garland | Obstetrics & Gynecology | 834 N Seminary St, Galesburg, IL 61401-2852 | 2008-07-01 |
| 1275710477 | Tara Lynn Baum | Obstetrics & Gynecology | 834 N Seminary Street, Suite 402, Galesburg, IL 61401-0500 | 2008-01-30 |
| 1104002690 | Vladimir Strunin | Obstetrics & Gynecology | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2008-01-14 |
| 1912097858 | Jeffrey A. Baumgardner, M.d. & Associates Ob/gyn LLC | Obstetrics & Gynecology | 940 N Henderson St, Galesburg, IL 61401-2520 | 2006-10-13 |
| 1659308922 | Knox Ob-gyn, Ltd | Obstetrics & Gynecology | 834 N Seminary St, Suite 402, Galesburg, IL 61401-2852 | 2006-06-26 |
| 1487648317 | Daniel K Piper | Obstetrics & Gynecology | 834 N Seminary St, Suite 402, Galesburg, IL 61401-2852 | 2005-09-07 |
| 1700881471 | James Cecil | Obstetrics & Gynecology | 834 N Seminary St, Ste 501, Galesburg, IL 61401-2852 | 2005-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162210 | Clair L Casagrande | Obstetrics & Gynecology | 1300 Franklin Ave Ste 330, Normal, IL 61761-4204 | 2020-10-23 |
| 1699382531 | Contemporary Ob/gyn Chicago, Pllc | Obstetrics & Gynecology | 2007 S State St, Chicago, IL 60616-2173 | 2020-09-24 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1851910210 | Wayne Richard Burrows | Obstetrics & Gynecology | 1412 S Diamond St, South Jacksonville, IL 62650-3143 | 2020-04-15 |
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1962050971 | Jessica Erin Buesing | Obstetrics & Gynecology | 27790 W Highway 22 Ste 37, Barrington, IL 60010-2396 | 2019-09-03 |
| 1235784760 | Gynecologic Surgery & Menopause Solutions PC | Obstetrics & Gynecology | 1890 Silver Cross Blvd Ste 445, New Lenox, IL 60451-9622 | 2019-08-01 |
| 1477105187 | Anthony Greis | Obstetrics & Gynecology | 540 Lake Cook Road, Suite 300, Deerfield, IL 60015 | 2019-07-12 |
| 1164980769 | Hanna Legator | Obstetrics & Gynecology | 1875 Dempster St Ste 300, Park Ridge, IL 60068-1186 | 2019-03-04 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.