Active NPI
Shalanda Verjean King
- Developmental Therapist
- Lansing, IL
National Provider Identifier
1154984987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 2959 191St St
Lansing, IL 60438-3703 - Phone
- (708) 465-3242
- NPI assigned
- Apr 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
2959 191St St
Lansing, IL 60438-3703
Mailing address
10218 S 84TH Terace
Palos Hills, IL 60465-1376
Phone (708) 465-3242
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681603200000",
"number": "1154984987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10218 S 84TH TERACE",
"city": "PALOS HILLS",
"state": "IL",
"postal_code": "604651376",
"telephone_number": "708-465-3242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2959 191ST ST",
"city": "LANSING",
"state": "IL",
"postal_code": "604383703",
"telephone_number": "708-465-3242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "SHALANDA",
"middle_name": "VERJEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-17",
"last_updated": "2023-04-16",
"certification_date": "2023-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lansing, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.