Kenyatta Shelton

NPI #1376231696 in Chicago, Illinois

Provider Information

NPI Number: 1376231696
Entity Type: Individual
Name: Kenyatta Shelton
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other
Enumeration Date: Apr 25, 2023
Last Updated: Apr 25, 2023

Practice Location

Address: 5135 W WASHINGTON BLVD
City: Chicago
State: Illinois
ZIP Code: 60644-3441
Phone: (773) 642-7314

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietetic Technician, Registered	136A00000X
Technician, Other	247200000X	Primary

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