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).
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
1512 W Reynolds St Ste A, Pontiac, IL 617649788 | 8158426551 | 8158444106 |
Street Address |
2005 JACOBSSEN DR STE A |
City | NORMAL |
State | IL |
Zip Code | 61761-6288 |
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 |
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 |
Find all providers in zip 61761 |
Taxonomy Code | 364SA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Adult Health |
Definition to come... |
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 |
Find all providers with the same taxonomy |
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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.