Provider Demographics
NPI:1790034387
Name:HARRIS, ESTHER M (APN)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:ESTHER
Other - Middle Name:M
Other - Last Name:SHANOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:34121 N US HIGHWAY 45 STE 210
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1774
Mailing Address - Country:US
Mailing Address - Phone:874-732-1354
Mailing Address - Fax:
Practice Address - Street 1:34121 N US HIGHWAY 45 STE 210
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1774
Practice Address - Country:US
Practice Address - Phone:224-602-3472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009777363LF0000X
IL209.009777363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily