NPIMap

Organization Active NPI

Dr. Shantelle and Associates, LTD

  • Clinical Psychologist
  • Naperville, IL
National Provider Identifier
1639510167
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DR. SHANTELLE AND ASSOCIATES, LTD
Practice address
552 S Washington St Ste 115
Naperville, IL 60540-6669
Phone
(312) 339-9832
Fax
(331) 999-3971
NPI assigned
Jul 12, 2013
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Dr. Shantelle Whitehead, PSYDNPI 1093008203
Title
Owner
Phone
(312) 339-9832

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

552 S Washington St Ste 115
Naperville, IL 60540-6669

Mailing address

552 S Washington St Ste 115
Naperville, IL 60540-6669
Phone (312) 339-9832

Other practice location 1

289 83rd Street
C
Burr Ridge, IL 60527
Phone (630) 891-3027 ext. 103

National Provider Directory

National Provider Directory

Locations

552 S Washington St
Ste 115
Naperville, IL 60540
Phone (312) 339-9832

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1639510167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 S WASHINGTON ST STE 115",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406669",
            "telephone_number": "312-339-9832",
            "fax_number": "630-857-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 S WASHINGTON ST STE 115",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406669",
            "telephone_number": "312-339-9832",
            "fax_number": "331-999-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 83rd Street",
            "address_2": "C",
            "address_purpose": "LOCATION",
            "city": "Burr Ridge",
            "state": "IL",
            "postal_code": "60527",
            "country_code": "US",
            "telephone_number": "630-891-3027 x103",
            "fax_number": "630-468-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. SHANTELLE AND ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "SHANTELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-339-9832",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.