Provider Demographics
NPI:1023350204
Name:BROOME, SHELIA M (APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:M
Last Name:BROOME
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:SHELIA
Other - Middle Name:
Other - Last Name:OLDHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN, FNP-BC
Mailing Address - Street 1:2650 WARRENVILLE ROAD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60515
Mailing Address - Country:US
Mailing Address - Phone:773-577-8188
Mailing Address - Fax:
Practice Address - Street 1:7447 W. TALCOTT AVE
Practice Address - Street 2:SUITE 512
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631
Practice Address - Country:US
Practice Address - Phone:773-577-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.010169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily