Individual
CHANELLE SHAKIRA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-6000
Mailing address
3800 S OCEAN DR STE 209, HOLLYWOOD, FL 33019-2915
(800) 226-8874
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.088120
IL
208600000X
Surgery Physician
Primary
2024-03322
NC
Other
Enumeration date
03/23/2020
Last updated
08/04/2026
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