Individual
TAMARA SHASTEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3755 E MAIN ST STE 190, SAINT CHARLES, IL 60174-2463
(630) 549-6245
(630) 701-9500
Mailing address
3755 E MAIN ST STE 190, SAINT CHARLES, IL 60174-2463
(630) 549-6245
(630) 701-9500
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209007817
IL
363LP0200X
Pediatric Nurse Practitioner
NP14669
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN619027
—
CA
Enumeration date
02/23/2007
Last updated
12/22/2022
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