Provider Demographics
NPI:1467992974
Name:VROMAN, SHELLY (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:
Last Name:VROMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12496 E 150TH ST
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:IL
Mailing Address - Zip Code:61273-9243
Mailing Address - Country:US
Mailing Address - Phone:097-367-4633
Mailing Address - Fax:
Practice Address - Street 1:12496 E 150TH ST
Practice Address - Street 2:
Practice Address - City:ORION
Practice Address - State:IL
Practice Address - Zip Code:61273-9243
Practice Address - Country:US
Practice Address - Phone:097-367-4633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015626363LA2100X
IL209015626363LA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209015626Medicaid
IL2016024304OtherANCC
ILMV4235138OtherDEA