Individual
SHANNON RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
745 FLETCHER DR STE 301, ELGIN, IL 60123-4750
(847) 741-0398
(847) 741-0549
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-009287
IL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
06/24/2022
Last updated
04/21/2023
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