Individual
SHANNON GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(888) 824-0200
Mailing address
1816 S CALUMET AVE, CHICAGO, IL 60616-1404
(570) 899-3450
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
209030081
IL
Other
Enumeration date
07/16/2024
Last updated
11/26/2024
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