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DR. SHASHONK ILLAM PSY.D.
NPI 1104432228
Student in an Organized Health Care Education/Training Program in Jacksonville, FL

Active since September 23, 2020
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207(904) 202-8000 Get Directions Write a Review

NPPES record last updated: July 5, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 5, 2024, Sep 23, 2020 (2 updates tracked since 2020).

About Dr. Shashonk Illam Psy.d. NPPES

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

DR. SHASHONK ILLAM PSY.D. (NPI 1104432228) is an individual student in an organized health care education/training program in Jacksonville, Florida and active in the NPI registry since September 2020.

NPPES Registry Identity

NPI1104432228
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. SHASHONK ILLAMCredential: PSY.D.
Location Address800 PRUDENTIAL DRJacksonville, FL 32207-8202
Mailing Address800 Prudential DrJacksonville, FL 32207-8211 · (904) 202-8000
Phone(904) 202-8000
Sole ProprietorNo
Enumeration DateSeptember 23, 2020
Last NPPES UpdateJuly 5, 20242 updates tracked since enumeration
NPPES CertifiedJuly 5, 2024
✔ NPI 1104432228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
800 PRUDENTIAL DR, Jacksonville, FL 32207
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Other Providers at the Same Location NPPES 20

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

ERIN M SCHOLZ MS CCC-SLP
Speech-Language Pathologist
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
TERRI TURNER TOMLINSON MSC CC-SLP
Speech-Language Pathologist
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
MICHELLE SENIA ANTONIO PT
Physical Therapist
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
ELIZABETH ANN POSTUPACK NURSE PRACTITIONER
Nurse Practitioner (Neonatal)
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 244-4242
ALYSSA KAY MOULDS CAA
Anesthesiologist Assistant
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
JAMEY MEDDERS CAA
Anesthesiologist Assistant
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
DR. DAVID ANDREW HOLLOMAN MD
Pathology (Anatomic Pathology & Clinical Pathology)
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (843) 323-8883
MR. BRADLEY JAMES WINE RN
Registered Nurse (Medical-Surgical)
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000

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 Shashonk Illam's NPI number?

The NPI number for Shashonk Illam is 1104432228. It was assigned to this individual provider in the NPPES registry on September 23, 2020.

Where is Shashonk Illam located?

Shashonk Illam practices at 800 Prudential Dr, Jacksonville, FL 32207. The listed phone number is (904) 202-8000.

What is Shashonk Illam's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Shashonk Illam was last updated on July 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.