JERRY SHELBY (NPI# 1194355685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194355685 |
| Entity Type | Individual |
| Full Name | JERRY SHELBY |
| Credential | NP |
| Practice Address |
301 Madison St Joliet IL 60435-6549 |
| Mailing Address |
1860 Paysphere Cir Chicago IL 60674-0018 |
| Practice Telephone | 8157401900 |
| Mailing Telephone | 6304699200 |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209020743 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831497841 | Jerry Anthony Shelby IIi | Pharmacist | 4361 Highway 24, Anderson, SC 29626-5214 | 2011-03-01 |
| Street Address |
301 MADISON ST |
| City | JOLIET |
| State | IL |
| Zip Code | 60435-6549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477511863 | Woo Chan Kim | Anesthesiology | 301 Madison St, Joliet, IL 60435-6557 | 2006-05-03 |
| 1982246229 | Jennifer Thompson | Nurse Practitioner | 301 Madison St, Joliet, IL 60435-6549 | 2019-10-08 |
| 1073067583 | Annette Bennett-otto | Nurse Practitioner | 301 Madison St, Joliet, IL 60435-6549 | 2016-08-12 |
| 1891140554 | Eleanor Harward | Physician Assistant | 301 Madison St, Suite 280, Joliet, IL 60435-6549 | 2016-05-02 |
| 1477918613 | Sheryl Burcenski | Nurse Practitioner | 301 Madison St, Suite 300, Joliet, IL 60435-6549 | 2015-12-15 |
| 1356716989 | Kelly Morris | Nurse Practitioner | 301 Madison St, Suite 300, Joliet, IL 60435 | 2015-12-08 |
| 1659740033 | Presence Hospitals Prv | Pediatrics | 301 Madison St, Suite 302, Joliet, IL 60435-6549 | 2015-09-16 |
| 1467859454 | Amanda Rae Benjamin | Nurse Practitioner | 301 Madison St, #300, Joliet, IL 60435-6549 | 2014-11-19 |
| 1568861094 | Laurel K. Alexander | Registered Nurse | 301 Madison St, Suite 207, Joliet, IL 60435-6549 | 2014-08-20 |
| 1770907289 | Women's Health and Wellness, LLC | Obstetrics & Gynecology | 301 Madison St, Suite 120, Joliet, IL 60435-6549 | 2014-02-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851889018 | Chime Ajiere | Nurse Practitioner | 511 Theodore St, Joliet, IL 60435 | 2018-04-24 |
| 1740791284 | Melanie Presnak | Speech-Language Pathologist | 1207 N Larkin Ave, Joliet, IL 60435 | 2017-10-23 |
| 1831618883 | Jeriel Marsena Quarles | Licensed Practical Nurse | 1617 W Jefferson Street, Joliet, IL 60435 | 2017-09-11 |
| 1053769760 | Cody Hutchinson | Physical Therapy Assistant | 2943 W Jefferson St, Joliet, IL 60435 | 2016-06-03 |
| 1659748549 | Megan Ryab | Massage Therapist | 501 Wilcox St, Joliet, IL 60435 | 2015-08-26 |
| 1922416197 | Kodo Care, Inc. | Pharmacy | 221 Springfield Avenue, Suite A, Joliet, IL 60435 | 2014-07-31 |
| 1528489739 | My Family Doc LLC | Family Medicine | 2001-03 Essington Rd, Joliet, IL 60435 | 2013-12-16 |
| 1184973869 | R A Lombardi Dds PC | Dentist | 3011 Theodore St., Joliet, IL 60435 | 2012-09-10 |
| 1245546076 | Kelly Rae Lesemann | Chiropractor | 1011 Essington Road, Joliet, IL 60435 | 2010-08-31 |
| 1932413697 | Ann E Todd | Optometrist | 1521 Essington Road, Everything In Sight, Joliet, IL 60435 | 2010-08-04 |
| Find all providers in zip 60435 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467090308 | Lisa Trevino | Nurse Practitioner | 301 Madison St Ste 240, Joliet, IL 60435-6549 | 2019-12-10 |
| 1386207306 | Wanda Matthews | Nurse Practitioner | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2019-04-16 |
| 1881150860 | Sarah Dean | Nurse Practitioner | 1051 Essington Rd, Joliet, IL 60435-2801 | 2019-02-14 |
| 1235603713 | Jennifer M Alamillo | Nurse Practitioner | 333 Madison St, Joliet, IL 60435-8200 | 2019-01-17 |
| 1891277646 | Amber Marie Vladika | Nurse Practitioner | 333 Madison St, Joliet, IL 60435-8200 | 2018-08-29 |
| 1992286868 | Christopher Michael Gloude | Nurse Practitioner | 301 Madison St Ste 207, Joliet, IL 60435 | 2018-08-28 |
| 1114417391 | Tamara Baird | Nurse Practitioner | 333 Madison St, Joliet, IL 60435-8200 | 2018-05-14 |
| 1033623129 | Maureen Ann Gorszczyk | Nurse Practitioner | 250 Water Stone Cir, Joliet, IL 60431-8313 | 2017-11-28 |
| 1033621024 | Stacey Rogers | Nurse Practitioner | 2319 Manhattan Rd, Joliet, IL 60433-8605 | 2017-10-30 |
| 1164956918 | Shanita Valentine | Nurse Practitioner | 2100 Glenwood Ave, Joliet, IL 60435 | 2017-04-19 |
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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.