Individual provider Active NPI

Hilary Shaw, BS, IBCLC

  • Lactation Consultant (Non-RN)
  • Rock Island, IL
National Provider Identifier
1033921499
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-107074 Issued in VA
Practice address
2112 25TH Ave
Rock Island, IL 61201-5317
Phone
(309) 558-2880
Fax
(309) 794-7091
NPI assigned
Jan 23, 2025
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Lactation Consultant (Non-RN)Group: 193200000X MULTI-SPECIALTY GROUP 174N00000X L-107074 VA Primary

Addresses

Primary practice location

2112 25TH Ave
Rock Island, IL 61201-5317

Mailing address

2112 25TH Ave
Rock Island, IL 61201-5317
Phone (309) 558-2880

Other identifiers 1

IdentifierTypeStateIssuer
005MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hshaw@rockislandcountyil.gov Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
L-107074VAMDLactation Consultant (Non-RN)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1033921499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 25TH AVE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015317",
            "telephone_number": "309-558-2880",
            "fax_number": "309-794-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 25TH AVE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015317",
            "telephone_number": "309-558-2880",
            "fax_number": "309-794-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "HILARY",
        "credential": "BS, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": "VA",
            "license": "L-107074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hshaw@rockislandcountyil.gov",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2112 25th Ave",
            "city": "Rock Island",
            "state": "IL",
            "country_code": "US",
            "postal_code": "612015317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.