Provider Demographics
NPI:1023699113
Name:MCCALLISTER, SHELBY (PSYD)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:MCCALLISTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:
Other - Last Name:STINGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 W RHODES ST
Mailing Address - Street 2:
Mailing Address - City:THOMASBORO
Mailing Address - State:IL
Mailing Address - Zip Code:61878-9740
Mailing Address - Country:US
Mailing Address - Phone:217-418-0733
Mailing Address - Fax:
Practice Address - Street 1:1900 E MAIN ST # 103R163A
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-5100
Practice Address - Country:US
Practice Address - Phone:217-554-5202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program