Provider Demographics
NPI:1932413077
Name:GRIGGS, SHANTE (PHARMD, DN)
Entity Type:Individual
Prefix:DR
First Name:SHANTE
Middle Name:
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:PHARMD, DN
Other - Prefix:DR
Other - First Name:SHANTE
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, DN
Mailing Address - Street 1:320 E 21ST ST UNIT 405
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4979
Mailing Address - Country:US
Mailing Address - Phone:312-872-7232
Mailing Address - Fax:
Practice Address - Street 1:3330 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-4001
Practice Address - Country:US
Practice Address - Phone:773-282-2686
Practice Address - Fax:773-282-2688
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181000392133N00000X, 174400000X, 208100000X, 2081N0008X, 2081P2900X, 2081S0010X, 172P00000X
133NN1002X, 174H00000X
NM01013172P00000X, 204C00000X, 208100000X
IL051292165183500000X, 1835N1003X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No174400000XOther Service ProvidersSpecialist
No174H00000XOther Service ProvidersHealth Educator
No183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine