Provider Demographics
NPI:1982162848
Name:BROWN, SHAMEKA CHANTE
Entity Type:Individual
Prefix:MRS
First Name:SHAMEKA
Middle Name:CHANTE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 AMERICANA CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-3688
Mailing Address - Country:US
Mailing Address - Phone:618-420-2976
Mailing Address - Fax:
Practice Address - Street 1:241 AMERICANA CIR
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-3688
Practice Address - Country:US
Practice Address - Phone:618-420-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist