Shaw Community Integration Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SHAW COMMUNITY INTEGRATION SERVICES

Doing business as

SCIS Agency

Practice address

8119 S Vernon Ave
Chicago, IL 60619-4913

Phone

(773) 952-1965

Fax

(708) 810-9792

NPI assigned

Feb 5, 2020

Last updated

Feb 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Rhonda Jefferson, RN

Title

Registered Nurse

Phone

(773) 952-1965

Specialties & licenses 2

Addresses

Other names 1

• SCIS Agency Doing business as

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1710519046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8119 S VERNON AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606194913",
            "telephone_number": "773-952-1965",
            "fax_number": "708-810-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8119 S VERNON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606194913",
            "telephone_number": "773-952-1965",
            "fax_number": "708-810-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAW COMMUNITY INTEGRATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "773-952-1965",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCIS Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colleen Shaughnessy, N.P.
• Robert James Shaughnessy, CRNA
• Mary Shaver
• Zachary McDonald Shaver
• Andrea Leigh Shavitz, D.C.
• Toria Shaw Morawski, LSW
• Alexander Shaw, DO
• Alison Shaw, APN
• Barbara Shaw, APN
• Barbara I Shaw, MSW, MHP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Chicago, IL
• Providers in Chicago, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

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