Loni Leeann Shouse

Individual provider Active NPI Attendant Care Provider · Rushview, IL

NPI 1770139784 · NPPES record last updated Aug 15, 2019

Key facts

NPI
1770139784
Entity type
Individual (NPI type 1)
Primary specialty
Attendant Care Provider 3747A0650X
Practice address
3 Golf View Acres
Rushview, IL 62681
Phone
(217) 248-9994
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X Yes

Addresses

Primary practice location

3 Golf View Acres
Rushview, IL 62681

Mailing address

14175 Schuman Rd
Browning, IL 62624
Phone (217) 617-8220

Sources for this page

Verify at the official NPI Registry.