Active NPI
Shaulia Robinson
- Licensed Practical Nurse
- Lynwood, IL
National Provider Identifier
1194221515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 043111657
- Practice address
- 19400 N Creek Dr
Lynwood, IL 60411-9608 - Phone
- (708) 985-3040
- Fax
- (708) 474-8144
- NPI assigned
- Apr 4, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043111657 | IL | Primary |
Addresses
Primary practice location
19400 N Creek Dr
Lynwood, IL 60411-9608
Mailing address
17746 Oak Park Ave
Tinley Park, IL 60477-3936
Phone (708) 444-1012
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043111657 | IL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522800000000",
"number": "1194221515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17746 OAK PARK AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604773936",
"telephone_number": "708-444-1012",
"fax_number": "708-614-7831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19400 N CREEK DR",
"city": "LYNWOOD",
"state": "IL",
"postal_code": "604119608",
"telephone_number": "708-985-3040",
"fax_number": "708-474-8144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "SHAULIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-04",
"last_updated": "2018-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IL",
"license": "043111657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.