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Organization

SHANELL'S PSYCHIATRY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANELL GLADSON (PRESIDENT)
(309) 229-0799
Entity
Organization

Contact information

Practice address
4615 CORREL AVE, BARTONVILLE, IL 61607-2618
(833) 221-4169
Mailing address
8420 N KNOXVILLE AVE STE C, PEORIA, IL 61615-2032
(309) 229-0799

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
08/05/2025
Last updated
11/13/2025
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