Individual
MS. SHADON MICHELE ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
4820 S KING DR, APT. 1S, CHICAGO, IL 60615-1349
(312) 320-2844
(708) 529-5868
Mailing address
4820 S KING DR, APT. 1S, CHICAGO, IL 60615-1349
(312) 320-2844
(708) 529-5868
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/08/2012
Last updated
03/02/2013
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