Basic Information
| Provider Information | |||||||||
| NPI: | 1073120010 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHIKANY | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | RENEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 675 N SAINT CLAIR ST STE 14-200 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606115966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126957382 | ||||||||
| FaxNumber: | 3126950014 | ||||||||
| Practice Location | |||||||||
| Address1: | 675 N SAINT CLAIR ST FL 14 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606115975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129268347 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2020 | ||||||||
| LastUpdateDate: | 11/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 149.017196 | IL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.