MS. SHANNA MARIE WIDERA RN APN NPI 1790710531

NPI Information

  • NPI: 1790710531
  • Provider Name: MS. SHANNA MARIE WIDERA, RN, APN
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 225 E CHICAGO AVE
    BOX #59
    CHICAGO, IL
    ZIP 60611
  • Phone: (312) 227-6778

Map and Directions

Get Directions

NPI Details

MS. Shanna Marie Widera, RN, APN is a pediatrics nurse practitioner in Chicago, IL. MS. Shanna Marie Widera, RN, APN NPI is 1790710531. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

225 E CHICAGO AVE
BOX #59
CHICAGO, IL
ZIP 60611-991
Phone: (312) 227-6778
Fax: (312) 227-9413

The NPI 1790710531 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 11/21/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics209004579ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI