Shakeela Brown
Individual provider Active NPI Rehabilitation Counselor · Du Quoin, IL
NPI 1104331537 · NPPES record last updated Dec 7, 2017
Key facts
- NPI
- 1104331537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rehabilitation Counselor 225C00000X
- Practice address
- 1016 S Madison St
Du Quoin, IL 62832-2442 - Phone
- (618) 542-4357
- Fax
- (618) 542-3442
- NPI assigned
- Dec 7, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | Yes |
Addresses
Primary practice location
1016 S Madison St
Du Quoin, IL 62832-2442
Mailing address
1016 S Madison St
Du Quoin, IL 62832-2442
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376130900001 | Medicaid | IL |
Other providers in Du Quoin, IL
- Sarah Bjorling
- Erica Lee Blankenship
- Autumn Brooke Boyd
- Rachel Jane Bozarth
- Natalie Brand
- Suzanne Burge
- Mitchelle Calderon
- Ellen M Chapman Pogue
- Sydnie Chard
- Christopher Greater Area Rural Health Planning Corporation
All providers in Du Quoin, IL · Rehabilitation Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.