Provider Demographics
NPI:1104358035
Name:SHINHOSTER, JANELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:
Last Name:SHINHOSTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 239
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-0239
Mailing Address - Country:US
Mailing Address - Phone:630-752-9725
Mailing Address - Fax:630-752-9726
Practice Address - Street 1:1N141 COUNTY FARM RD
Practice Address - Street 2:SUITE 130
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-2032
Practice Address - Country:US
Practice Address - Phone:630-752-9725
Practice Address - Fax:630-752-9726
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009278103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical