Individual
SHANNON WATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
360 STATION DRIVE, 3RD FLOOR, CRYSTAL LAKE, IL 60014-6260
(815) 477-2310
(815) 356-2335
Mailing address
13707 W JACKSON ST, WOODSTOCK, IL 60098-3188
(815) 337-1871
(815) 338-6297
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036106885
IL
Other
Enumeration date
09/16/2005
Last updated
12/04/2024
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