Provider Demographics
NPI:1962442608
Name:SHAW, BARBARA (APN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 N MOZART ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2718
Mailing Address - Country:US
Mailing Address - Phone:773-235-7036
Mailing Address - Fax:773-235-7036
Practice Address - Street 1:845 S DAMEN AVE
Practice Address - Street 2:INTEGRATED HEALTH CARE, UIC COLLEGE OF NURSING, 9TH FL.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3727
Practice Address - Country:US
Practice Address - Phone:773-537-3950
Practice Address - Fax:773-435-0119
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209001421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily