SHANNON L LAESCH


Address: 2005 Jacobssen Dr Ste A, Normal, IL 61761-6288
Phone: 3098070384

SHANNON L LAESCH (NPI# 1033559802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033559802
Entity Type Individual
Full Name SHANNON L LAESCH
Credential APRN
Practice Address 2005 Jacobssen Dr Ste A
Normal
IL 61761-6288
Practice Telephone 3098070384
Practice Fax Number 3096619571
Mailing Telephone 3098070384
Mailing Fax Number 3096619571
Enumeration Date 2013-06-26
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 364SA2200X Clinical Nurse Specialist
Specialization: Adult Health
209010219 IL Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1512 W Reynolds St Ste A, Pontiac, IL 617649788 8158426551 8158444106

Office Location

Street Address 2005 JACOBSSEN DR STE A
City NORMAL
State IL
Zip Code 61761-6288

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104391739 Central Illinois Center for Wellness, LLC Clinic/Center 2005 Jacobssen Dr Ste A, Normal, IL 61761-6288 2018-10-10
1770027930 Pro Podiatry, LLC Podiatrist 2005 Jacobssen Dr Ste A, Normal, IL 61761-6288 2016-12-07

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629681796 Brittany Nicole Mekley Nurse Practitioner 201 N. University, Normal, IL 61761 2020-08-28
1679108971 Krystal Halliday Occupational Therapist 1815 N Towanda Barnes Rd, Normal, IL 61761 2020-03-06
1265915474 Laine E Burek Nurse Practitioner 1765 Bradford Ln., Normal, IL 61761 2018-09-13
1801389986 Ashley Michelle James Specialist/Technologist 347 S. University St, Normal, IL 61761 2018-06-12
1447750708 Shelley R. Ruch Specialist/Technologist, Other 1604 Visa Drive, Ste 1, Normal, IL 61761 2018-02-13
1497275069 Mclean County Nursing Home Non-emergency Medical Transport (VAN) 901 N. Main St, Normal, IL 61761 2017-06-23
1235673666 Megan Threm Registered Nurse 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 2016-12-04
1437513553 Tiesha Smith Specialist 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 2016-04-06
1285031658 New Day Recovery Community/Behavioral Health 402 Summit, Normal, IL 61761 2014-12-01
1174927701 Alyssa Marie Bruck Occupational Therapist 700 N Walnut St, Normal, IL 61761 2014-10-10
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Taxonomy Information

Taxonomy Code 364SA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1942668355 Joannne Geralyn Delany Clinical Nurse Specialist 13133 Meadowview Ln, Homer Glen, IL 60491-9155 2016-02-01
1427323898 Kara Michelle Aalfs Clinical Nurse Specialist 6n910 Gilmore Dr, Saint Charles, IL 60175-8314 2012-03-18
1528351962 Kristi Kae Williams Clinical Nurse Specialist 530 Ne Glenoak Avenue Pob Suite 108, Peoria, IL 61603-3117 2011-05-18
1427356336 Lissa J Diefendorf Clinical Nurse Specialist 403 W Corrington Ave, Peoria, IL 61604-2803 2011-03-02
1326354358 Sheila A Harmon Clinical Nurse Specialist 654 East 47th St, Access Booker Family Health Center, Chicago, IL 60653-4224 2010-08-27
1689283723 Michelle Marie Lovsey Clinical Nurse Specialist 1 Saint Anthonys Way, Alton, IL 62002-4568 2020-07-24
1053942318 Mary Sue Dailey Clinical Nurse Specialist 3815 Highland Ave, Downers Grove, IL 60515-1500 2020-01-27
1316448947 Cheryl A Pahl Clinical Nurse Specialist 801 S Milwaukee Ave, Libertyville, IL 60048-3204 2018-02-28
1144728155 Euphemia M Connell Clinical Nurse Specialist 5841 S Maryland Ave, Chicago, IL 60637-1443 2018-01-24
1881101350 Kaylea M Reeves Clinical Nurse Specialist 2160 S 1st Ave, Maywood, IL 60153 2018-01-05
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Competitor

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City NORMAL
Zip Code 61761

Improve Information

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Dataset Information

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.

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