Shamrock Services, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

94S227 Issued in IL

Legal business name

SHAMROCK SERVICES, LLC

Practice address

4219 Lincolnshire Dr
Mount Vernon, IL 62864-2157

Phone

(618) 242-2169

Fax

(618) 242-9770

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Bridget P McDonagh

Title

Partner

Phone

(618) 244-7701

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306990601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2369",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628640046",
            "telephone_number": "618-244-7701",
            "fax_number": "618-244-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4219 LINCOLNSHIRE DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642157",
            "telephone_number": "618-242-2169",
            "fax_number": "618-242-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMROCK SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDONAGH",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "618-244-7701"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "IL",
            "license": "94S227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CILA LICENSE",
            "identifier": "94S227",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Select Physical Therapy Holdings, Inc.
• Hammad Shafqat, MD
• Adit Shah, MD
• Youssef Jamal Shammaa, M.D.
• Shamrock Services Group
• Fadi Michel Shamsham, M.D.
• Amanda Barton Shelton, CNM
• Annette V Shores, M.D.
• Kellie Nicole Sigrist, MHP
• Leslie L Simonton-Smith, M.D.

• Adult Care Home Facility in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Adult Care Home Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.