Shavon Petties, CST, CSFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

238-000744 Issued in IL

Practice address

815 Pasquinelli Dr
Westmont, IL 60559-1276

Phone

(630) 654-2515

Fax

(630) 654-2516

NPI assigned

Sep 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shavon Harshaw Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1992477897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 PASQUINELLI DR",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591276",
            "telephone_number": "630-654-2515",
            "fax_number": "630-654-2516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 W Higgins Rd",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601953203",
            "country_code": "US",
            "telephone_number": "847-285-4200",
            "fax_number": "847-885-0130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIES",
        "first_name": "SHAVON",
        "credential": "CST, CSFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "238-000744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IL SURGICAL ASSISTANT LICENSE",
            "identifier": "238.000744",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sharshaw307023@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "815 Pasquinelli Dr",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605591276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHAVON",
            "last_name": "HARSHAW",
            "credential": "CSFA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgical Assistant in Westmont, IL
• Providers in Westmont, IL by specialty
• Surgical Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.