Individual provider Active NPI

Sharon N. McNeal, REGISTERED NURSE

  • Registered Nurse
  • Calumet City, IL
National Provider Identifier
1629458575
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041335808 Issued in IL
Practice address
1646 Harbor Ave
Apt. 2
Calumet City, IL 60409-1631
Phone
(312) 547-9514
Fax
(708) 360-3257
NPI assigned
Jun 5, 2015
Last updated
Jun 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041335808 IL Primary

Addresses

Primary practice location

1646 Harbor Ave
Apt. 2
Calumet City, IL 60409-1631

Mailing address

1646 Harbor Ave
Apt. 2
Calumet City, IL 60409-1631
Phone (312) 547-9514

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

LicenseStateTypeSpecialty
041335808ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1629458575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1646 HARBOR AVE",
            "address_2": "APT. 2",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604091631",
            "telephone_number": "312-547-9514",
            "fax_number": "708-360-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1646 HARBOR AVE",
            "address_2": "APT. 2",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604091631",
            "telephone_number": "312-547-9514",
            "fax_number": "708-360-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEAL",
        "first_name": "SHARON",
        "middle_name": "N.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-05",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041335808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.