Amanda Colleen Shanley | Chicago, IL • PECOS Search

Amanda Colleen Shanley

Social Worker

Behavioral Health & Social Service Providers

2342 N Janssen Ave, Chicago, IL 60614-3020

PECOS Enrollment

Based on the most recent information from CMS, provider Amanda Colleen Shanley does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1558908798
Provider Type
Individual
Full Name
Shanley, Amanda Colleen
Title
Ms.
Credential
LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/6/2019
Last Updated
12/6/2019

Contact Information

Practice Location

2342 N Janssen Ave, Chicago, IL 60614-3020

Unlisted Fax

Mailing Location

2342 N Janssen Ave, Chicago, IL 60614-3020

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 149.020364 Illinois