Individual
KELSEY LYNN DENNIS SHAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
404 N HERSHEY RD STE C, BLOOMINGTON, IL 61704-3560
(877) 381-6538
(312) 663-0504
Mailing address
500 W MONROE ST FL 18, CHICAGO, IL 60661-3759
(312) 663-1130
(312) 663-0504
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180008381
IL
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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