Provider Demographics
NPI:1134634488
Name:SOLT, SHELANE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHELANE
Middle Name:
Last Name:SOLT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ROBERT P WEIDLING DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60481-1679
Mailing Address - Country:US
Mailing Address - Phone:815-726-2200
Mailing Address - Fax:
Practice Address - Street 1:121 ROBERT P WEIDLING DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:IL
Practice Address - Zip Code:60481-1679
Practice Address - Country:US
Practice Address - Phone:815-726-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-016844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily