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SHANIQUA BLACKMAN
NPI 1063389336
Counselor - Mental Health in Lake Villa, IL

Active since October 21, 2025
600 W GRAND AVE, LAKE VILLA, IL 60046(847) 245-6276 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shaniqua Blackman NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANIQUA BLACKMAN (NPI 1063389336) is an individual mental health provider in Lake Villa, Illinois, licensed in Illinois (180.017610) and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1063389336
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHANIQUA BLACKMAN
Location Address600 W GRAND AVELake Villa, IL 60046-8034
Mailing Address11141 S Ashland AveChicago, IL 60643-3513 · (312) 230-8104
Phone(847) 245-6276
Sole ProprietorYes
Enumeration DateOctober 21, 2025
Last NPPES UpdateOctober 24, 2025
NPPES CertifiedOctober 21, 2025
✔ NPI 1063389336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IL · 180.017610
600 W GRAND AVE, Lake Villa, IL 60046
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLENDALE ASSOCIATION
Residential Treatment Facility, Emotionally Disturbed Children
600 W GRAND AVE
LAKE VILLA, IL 60046
Lake County (847) 356-2351
KELLY NICHOLE ECKHART APRN
Nurse Practitioner (Psychiatric/Mental Health)
600 W GRAND AVE
LAKE VILLA, IL 60046
Lake County (847) 245-6262
MS. MARAL BINNEBOSE MSW
Social Worker
600 W GRAND AVE
LAKE VILLA, IL 60046
Lake County (847) 627-1181

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shaniqua Blackman's NPI number?

The NPI number for Shaniqua Blackman is 1063389336. It was assigned to this individual provider in the NPPES registry on October 21, 2025.

Where is Shaniqua Blackman located?

Shaniqua Blackman practices at 600 W Grand Ave, Lake Villa, IL 60046. The listed phone number is (847) 245-6276.

What is Shaniqua Blackman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Shaniqua Blackman was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.