Provider Demographics
NPI:1548567357
Name:SHANKS, MORGAN LYNDSEY WININGER (ACNP-BC, RN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:LYNDSEY WININGER
Last Name:SHANKS
Suffix:
Gender:F
Credentials:ACNP-BC, RN, MSN
Other - Prefix:MISS
Other - First Name:MORGAN
Other - Middle Name:LYNDSEY
Other - Last Name:WININGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP-BC, RN, MSN
Mailing Address - Street 1:3815 HIGHLAND AVENUE
Mailing Address - Street 2:CRITICAL CARE PAVILION
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515
Mailing Address - Country:US
Mailing Address - Phone:630-275-7052
Mailing Address - Fax:317-948-8079
Practice Address - Street 1:3815 HIGHLAND AVENUE
Practice Address - Street 2:CRITICAL CARE PAVILION
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515
Practice Address - Country:US
Practice Address - Phone:317-948-8112
Practice Address - Fax:317-948-8079
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28165171163W00000X
IN71003309363LC0200X
IL209009601363LC0200X
IL041400941163W00000X
IN28165171A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse