Active NPI
Shirley Kathleen Comer, ACNS-BC, APN
- Family Medicine Physician
- Kankakee, IL
National Provider Identifier
1346760188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 209.016069
- Practice address
- 606 E Court St
Kankakee, IL 60901-4011 - Phone
- (815) 216-3346
- Fax
- (815) 348-6701
- NPI assigned
- Jun 22, 2017
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 209.016069 | IL | Primary |
Addresses
Primary practice location
606 E Court St
Kankakee, IL 60901-4011
Mailing address
1745 N Indiana St
Griffith, IN 46319-1105
Phone (219) 789-6649
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 |
|---|---|---|---|
| 209.016069 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498089600000",
"number": "1346760188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1745 N INDIANA ST",
"city": "GRIFFITH",
"state": "IN",
"postal_code": "463191105",
"telephone_number": "219-789-6649",
"fax_number": "708-235-2197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 E COURT ST",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609014011",
"telephone_number": "815-216-3346",
"fax_number": "815-348-6701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMER",
"first_name": "SHIRLEY",
"middle_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "ACNS-BC, APN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-22",
"last_updated": "2017-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "209.016069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kankakee, IL
- Ashley Noel Joyles Clark, MD
- Emily Claire Clyden, MHS, CCC-SLP/L
- Caitlyn Coburn, CRNA
- Karen J. Cohs-Murray, CRNA
- Jesse Coleman, DO
- Community Alternatives Illinois, Inc.
- Community Alternatives Illinois, Inc.
- Community Alternatives Illinois, Inc.
- Community Alternatives Illinois, Inc.
- Community Alternatives Illinois, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.