TRACI SHANKLIN (NPI# 1245661750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245661750 |
| Entity Type | Individual |
| Full Name | TRACI SHANKLIN |
| Other Name | TRACI SHIVERS |
| Credential | N.P. |
| Practice Address |
1890 Silver Cross Blvd St 350 New Lenox IL 60451-9524 |
| Mailing Address |
1507 Belleview Ave Rockdale IL 60436-2428 |
| Practice Telephone | 8157178737 |
| Practice Fax Number | 8157178699 |
| Mailing Telephone | 8156035319 |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2014-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209010966 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1890 SILVER CROSS BLVD ST 350 |
| City | NEW LENOX |
| State | IL |
| Zip Code | 60451-9524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841289691 | Mohammad Ashraf Toor | Internal Medicine | 1890 Silver Cross Blvd, Ste 320, New Lenox, IL 60451-9508 | 2005-10-14 |
| 1194373662 | Alyssa M Monsivais | Advanced Practice Midwife | 1890 Silver Cross Blvd, New Lenox, IL 60451-9524 | 2019-08-28 |
| 1346775574 | Andrew Hatfield | Nurse Practitioner | 1890 Silver Cross Blvd, Suite 570, New Lenox, IL 60451-9524 | 2017-04-25 |
| 1104367655 | Julia Grace Bania | Nurse Practitioner | 1890 Silver Cross Blvd, #210, New Lenox, IL 60451-9524 | 2017-03-16 |
| 1407390743 | Alison Barna | General Acute Care Hospital | 1890 Silver Cross Blvd, New Lenox, IL 60451-9524 | 2016-12-06 |
| 1215479621 | Lisa Abu-samra | Advanced Practice Midwife | 1890 Silver Cross Blvd, New Lenox, IL 60451-9524 | 2016-11-16 |
| 1841746567 | Becky Strilko | Registered Nurse | 1890 Silver Cross Blvd, New Lenox, IL 60451-9524 | 2016-09-01 |
| 1114370517 | Zafer Jawich Md Sc | Clinic/Center | 1890 Silver Cross Blvd, Ste 350, New Lenox, IL 60451-9524 | 2016-07-20 |
| 1154793412 | Forefront Dermatology, S.c. | Dermatology | 1890 Silver Cross Blvd, Suite 505, New Lenox, IL 60451 | 2015-10-27 |
| 1154704104 | Maria Wemple | Physician Assistant | 1890 Silver Cross Blvd, Suite 210, New Lenox, IL 60451-9524 | 2015-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871126227 | Forever Family Dental of New Lenox | Dentist | 202 Vancina Lane, New Lenox, IL 60451 | 2020-02-13 |
| 1699245662 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 115 East Maple St, New Lenox, IL 60451 | 2018-12-03 |
| 1093204778 | New Lenox Anesthesia LLC | Anesthesiology | 678 Cedar Crossing Dr, New Lenox, IL 60451 | 2018-05-08 |
| 1578068698 | My Medicar | Non-emergency Medical Transport (VAN) | 21625 S. Schoolhouse Rd, New Lenox, IL 60451 | 2018-03-29 |
| 1134646771 | Julianne M. Goudzwaard | Registered Nurse | 841 Buckboard Drive, New Lenox, IL 60451 | 2017-08-24 |
| 1063947422 | Silver Cross Ambulatory Surgery Center, LLC | Clinic/Center | 1003 Pawlak Parkway, New Lenox, IL 60451 | 2017-04-24 |
| 1386090041 | Lindsey Reimer | Speech-Language Pathologist | 3515 Golf Ave, New Lenox, IL 60451 | 2016-05-11 |
| 1295105484 | Alison Elaine Burchardt | Nurse Practitioner | 1890 Silver Cross Boulevard, Pavilion A, Suite 240, New Lenox, IL 60451 | 2015-09-30 |
| 1700278959 | Dental Professionals of Illinois, P.c | Dentist | 561 E Lincoln Hwy, New Lenox, IL 60451 | 2015-02-25 |
| 1912319146 | Teresea Bargewell | Counselor | 1049 E. Lincoln Hwy, Decision Point Counseling and Career Center, New Lenox, IL 60451 | 2014-05-22 |
| Find all providers in zip 60451 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780211102 | Nikki Marie Insalaco | Nurse Practitioner | 1900 Silver Cross Blvd # D, New Lenox, IL 60451-9509 | 2020-03-25 |
| 1114558632 | Allison Mangun | Nurse Practitioner | 1890 Silver Cross Blvd Ste 430, New Lenox, IL 60451-9545 | 2020-02-03 |
| 1497285100 | Gretchen Rae Mulheran | Nurse Practitioner | 1890 Silver Cross Blvd Ste 210, New Lenox, IL 60451-9626 | 2017-06-14 |
| 1669841177 | Julie K Bright-allott | Nurse Practitioner | 1890 Silver Cross Blvd Ste 375, New Lenox, IL 60451-9528 | 2015-09-15 |
| 1417556812 | Monica Figueroa | Nurse Practitioner | 1004 Pawlak Pkwy, New Lenox, IL 60451-9401 | 2020-10-19 |
| 1962038968 | Hollie Ann Nieland | Nurse Practitioner | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2020-03-21 |
| 1376177220 | Taylor Baldermann | Nurse Practitioner | 1900 Silver Cross Blvd, New Lenox, IL 60451 | 2020-03-01 |
| 1972144715 | Rebecca Mireles | Nurse Practitioner | 1900 Silver Cross Blvd, New Lenox, IL 60451-9509 | 2019-10-02 |
| 1669981916 | Stamatina Mancini | Nurse Practitioner | 1890 Silver Cross Blvd Ste 240, New Lenox, IL 60451-9528 | 2017-09-28 |
| 1275052243 | Lindsay Thorgesen | Nurse Practitioner | 1890 Silver Cross Blvd Ste 240, New Lenox, IL 60451-9528 | 2017-09-11 |
| Find all providers in NEW LENOX | ||||
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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.