Provider Demographics
NPI:1669047460
Name:SHEWMAKE, ALLISON K
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:K
Last Name:SHEWMAKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16145 LASALLE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473
Mailing Address - Country:US
Mailing Address - Phone:708-331-0711
Mailing Address - Fax:
Practice Address - Street 1:16145 LASALLE ST
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473
Practice Address - Country:US
Practice Address - Phone:708-331-0711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277.003215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine