Active NPI
Shelley McMahon
- Lactation Consultant (Non-RN)
- Villa Park, IL
National Provider Identifier
1740933027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Non-RN)
- License
- L-306335
- Practice address
- 121 E Jackson St
Villa Park, IL 60181-3252 - Phone
- (630) 915-9123
- NPI assigned
- Jan 27, 2022
- 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 |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-306335 | IL | Primary |
Addresses
Primary practice location
121 E Jackson St
Villa Park, IL 60181-3252
Mailing address
121 E Jackson St
Villa Park, IL 60181-3252
Phone (163) 091-5912
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 |
|---|---|---|---|
| L-306335 | IL | MD | Lactation Consultant (Non-RN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643241600000",
"number": "1740933027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 E JACKSON ST",
"city": "VILLA PARK",
"state": "IL",
"postal_code": "601813252",
"telephone_number": "163-091-5912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 E JACKSON ST",
"city": "VILLA PARK",
"state": "IL",
"postal_code": "601813252",
"telephone_number": "630-915-9123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON",
"first_name": "SHELLEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-27",
"last_updated": "2022-01-27",
"certification_date": "2022-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "IL",
"license": "L-306335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villa Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.