NPI 1376231696

Kenyatta Shelton

Practitioner Other Technician Chicago, IL

Practice location

Address: 5135 W Washington Blvd, Chicago, IL 60644-3441
Phone: (773) 642-7314

Registered specialties (2)

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X Licence 131014391 (IL)

Other Technician, Other providers in Illinois →

Registered Dietetic Technician

Dietary & Nutritional Service Providers Taxonomy 136A00000X Licence 131014391 (IL)

Other Dietetic Technician, Registered providers in Illinois →

Registry record

NPI: 1376231696
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Apr 2023
Record last updated: 25 Apr 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.