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Contact Information

KENYATTA SHELTON
5135 W WASHINGTON BLVD
CHICAGO, IL60644-3441
 Phone: 773-642-7314
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Technician, Other

247200000X 75 Slide Preparation Facility
 

Dietetic Technician, Registered

136A00000X
Indicates primary specialty

NPI Profile & details for KENYATTA SHELTON · (Female)

NPI # 1376231696
Status Active
Credentials
Entity Individual
Enumeration date 04/25/2023
Last updated 04/25/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 131014391
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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