Individual
MS. SHANELLE BINGGELI EISWIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
675 N SAINT CLAIR ST STE 19-100, CHICAGO, IL 60611
(312) 664-3278
(312) 695-1903
Mailing address
201 E HURON ST STE 11-140, CHICAGO, IL 60611-2968
(312) 664-3278
(312) 695-2461
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209017412
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IL
Enumeration date
12/02/2010
Last updated
10/21/2021
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