Provider Demographics
NPI:1316738362
Name:SHELTON, ROBIN (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:SHELTON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W AGATITE AVE APT 2508
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6214
Mailing Address - Country:US
Mailing Address - Phone:312-608-6488
Mailing Address - Fax:
Practice Address - Street 1:1835 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3701
Practice Address - Country:US
Practice Address - Phone:312-608-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041464812163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty