Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Shashonk Illam, PSYD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104432228

Dr. Shashonk Illam, PSYD is a Student in an Organized Health Care Education/Training Program in Jacksonville, Florida. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone: (904) 202-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1104432228
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedSeptember 23, 2020
Last updated in NPPESJuly 5, 2024
Certification dateJuly 5, 2024

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