Individual
IESHA SHANAE HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
762 PULASKI RD, CALUMET CITY, IL 60409-4018
(312) 937-8466
(312) 937-8466
Mailing address
762 PULASKI RD, CALUMET CITY, IL 60409-4018
(312) 937-8466
(312) 937-8466
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.133335
IL
Other
Enumeration date
08/05/2025
Last updated
11/20/2025
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