Individual
VICKI SHAWVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,BS
Contact information
Practice address
723 E MAIN ST, OLNEY, IL 62450-2619
(618) 393-7732
(618) 395-3123
Mailing address
723 E MAIN ST, OLNEY, IL 62450-2619
(618) 393-7732
(618) 395-3123
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
41200924
IL
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8030288
BLUECROSS/BLUESHIELD IL
IL
Enumeration date
08/20/2006
Last updated
09/11/2025
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