Most Relevant Information
Provider Data
| NPI Number: | 1003052655 |
| Provider Name: | SHIRLEY ANN SHAW |
| Entity Type: | Individual |
| Taxonomy Code: | 343900000X |
| Specialty: | Non-emergency Medical Transport (VAN) |
| License Number: | MC6805 |
Most Important Dates
| Enumeration Date: | 01/04/2009 |
| Last Updated: | 01/04/2009 |
Provider Practice Location
17851 GLADVILLE AVE
HOMEWOOD
IL
604301836
Practice Location Phone/Fax
| Phone: | 7733865355 |
| Fax: | 7089917835 |
Provider Mailing Location
17851 GLADVILLE AVE
HOMEWOOD
IL
604301836
Provider Mailing Phone/Fax
| Phone: | 7733865355 |
| Fax: | 7089917835 |