STACEY ANNE SHAW (NPI# 1356973762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356973762 |
| Entity Type | Individual |
| Full Name | STACEY ANNE SHAW |
| Credential | DNP |
| Practice Address |
5841 S Maryland Ave # Mc6082 Chicago IL 60637-1443 |
| Mailing Address |
22 N Aberdeen St Apt 405 Chicago IL 60607-3043 |
| Practice Telephone | 7738340497 |
| Practice Fax Number | 7738345964 |
| Mailing Telephone | 9134850754 |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 041415801 | IL | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209019812 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366922882 | Stacey L Shaw | Nurse Practitioner | 1690 Dunlawton Ave Ste 230, Port Orange, FL 32127-8980 | 2018-08-14 |
| 1093226789 | Stacey Lynn Shaw | Nurse Practitioner | 7600 E Florentine Rd Ste 201, Prescott Valley, AZ 86314-1295 | 2017-10-20 |
| 1912481342 | Stacey Scaggs Shaw | Pharmacist | 101 Hampton Ave, Pickens, SC 29671-2462 | 2018-09-21 |
| 1225574080 | Stacey Shaw | Registered Nurse | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-01-17 |
| 1841620184 | Stacey Shaw | Counselor | 9040 Reid St, Attn: Mchj-clq-c, Joint Base Lewis Mcchord, WA 98431-5353 | 2013-11-23 |
| 1407059439 | Stacey Shaw | Registered Nurse | 6705 Rangewood Dr, Colorado Springs, CO 80918-7300 | 2007-06-07 |
| 1326249566 | Stacey A Shaw | Social Worker | 5707 N 22nd St, Tampa, FL 33610-4350 | 2007-05-29 |
| Street Address |
5841 S MARYLAND AVE # MC6082 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60637-1443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548624604 | Reena Anand | Pediatrics | 5841 S Maryland Ave # Mc6082, Chicago, IL 60637-1443 | 2016-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263234 | Pooja Ramnani | Pharmacist | 5841 S Maryland Ace, Chicago, IL 60637 | 2020-04-10 |
| 1780220079 | Tara Coleman | Non-emergency Medical Transport (VAN) | 808 E. 63rd Street, Suite 135, Chicago, IL 60637 | 2019-11-21 |
| 1366003501 | Valerie Silas | Case Management | 6330 S King Drive, Chicago, IL 60637 | 2019-06-27 |
| 1205391620 | Derek Joseph Fiedler | Anesthesiology | University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 | 2019-02-11 |
| 1821573072 | Ugochinyere Ohaja | Registered Nurse | 5656 South Maryland Avenue, Chicago, IL 60637 | 2018-10-03 |
| 1053899138 | Won Hee Oh | Physician Assistant | 5841 S. Maryland Ave., Mc5040, Chicago, IL 60637 | 2018-08-01 |
| 1558854695 | Rasidat Adeduntan | Internal Medicine | 5841 S. Maryland Avenue, [7082], Chicago, IL 60637 | 2018-06-13 |
| 1194235283 | Melissa Ann Arangoa | Registered Nurse | 5841 S. Maryland Ave, Mc 1083, Chicago, IL 60637 | 2017-10-03 |
| 1558880633 | Marni Harris | Optometrist | 5841 S Maryland Ave # S421, Chicago, IL 60637 | 2017-09-11 |
| 1992235105 | Vidya Mahavadi | Pediatrics | 5841 S. Maryland Avenue, Mail Code 8016, Chicago, IL 60637 | 2017-06-20 |
| Find all providers in zip 60637 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669937231 | Colleen Ann Larkin | Nurse Practitioner | 10939 S Troy St, Chicago, IL 60655-2211 | 2019-02-07 |
| 1487160586 | Meghan Doepke Sullivan | Nurse Practitioner | 1030 N Clark St Ste 400, Chicago, IL 60610-5468 | 2017-12-27 |
| 1366955940 | Debra Chana Goldstein | Nurse Practitioner | 2732 W Chase Ave, Chicago, IL 60645-1313 | 2017-11-06 |
| 1588189260 | Larissa Marie Schulze | Nurse Practitioner | 737 N Michigan Ave Ste 820, Chicago, IL 60611-6659 | 2017-08-03 |
| 1164887295 | Meredith Murphy Mcintee | Nurse Practitioner | 5841 S Maryland Ave # Mc4065, Chicago, IL 60637-1443 | 2015-12-16 |
| 1215345442 | Tara Seider | Nurse Practitioner | 2707 W Ainslie St, Unit #3, Chicago, IL 60625-2715 | 2014-07-31 |
| 1447697982 | Emily Thurn | Nurse Practitioner | 225 E Chicago Ave Box 29, Chicago, IL 60611-2605 | 2013-05-23 |
| 1518231505 | Julianne Deschler Bertalmio | Nurse Practitioner | 1460 N. Halsted Street, Suite 402, Chicago, IL 60642 | 2012-03-08 |
| 1932478765 | Julie Elizabeth Martin | Nurse Practitioner | 225 E Chicago, 4 Ne, Chicago, IL 60611-2605 | 2011-12-22 |
| 1245532480 | Alexandra Wilson Benz | Nurse Practitioner | 225 E Chicago Ave # 93, Chicago, IL 60611-2991 | 2010-11-20 |
| Find all providers in CHICAGO | ||||
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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.