Individual
DR. NICOLE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5841 S MARYLAND AVE # MC1052, CHICAGO, IL 60637-1443
(773) 702-0529
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
125.074351
IL
2084P0800X
Psychiatry Physician
Primary
DR.0070056
CO
Other
Enumeration date
04/05/2019
Last updated
06/06/2023
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