Individual
JERRY SHELBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
24047 W LOCKPORT ST, PLAINFIELD, IL 60544-2205
(815) 201-0573
(815) 513-6178
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020743
IL
Other
Enumeration date
01/23/2020
Last updated
10/01/2025
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