Wali Khateeb Shakoor-Luqman I, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

145431-030 Issued in WI

Practice address

1513 Roosevelt Ave
Racine, WI 53406-4572

Phone

(262) 632-1113

Fax

(262) 632-1113

NPI assigned

Jun 13, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1285894147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 ROOSEVELT AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064572",
            "telephone_number": "262-632-1113",
            "fax_number": "262-632-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 ROOSEVELT AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064572",
            "telephone_number": "262-632-1113",
            "fax_number": "262-632-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKOOR-LUQMAN",
        "first_name": "WALI",
        "middle_name": "KHATEEB",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "145431-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38252200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooklyn Alyssa Seiler, RDN, CD, LDN
• Don Louis Selmo, DDS
• Raye Marie Serratos, APNP, PMHNP-BC
• Gregg Allen Seyler, DDS
• Mahmood S Shaikh, MD
• Laura Shanafelt, PHARMD
• Vijayashree P Shankar
• Molly J Sharp, MS, CCC-SLP
• Melissa Sharpe, PTA
• Bruce C Shawhan, D.C.

• Registered Nurse in Racine, WI
• Providers in Racine, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.