Provider Demographics
NPI:1902228851
Name:SHOSTEK SHIELDS, DENISE M (DC ND)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:M
Last Name:SHOSTEK SHIELDS
Suffix:
Gender:F
Credentials:DC ND
Other - Prefix:DR
Other - First Name:DENISE
Other - Middle Name:M
Other - Last Name:SHOSTEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC ND
Mailing Address - Street 1:1251 N PLUM GROVE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5609
Mailing Address - Country:US
Mailing Address - Phone:773-960-0737
Mailing Address - Fax:
Practice Address - Street 1:1251 N PLUM GROVE RD STE 100
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5609
Practice Address - Country:US
Practice Address - Phone:630-488-2376
Practice Address - Fax:847-519-0599
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2022-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor