Individual
MRS. MARY ANN SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD. LD.
Contact information
Practice address
1801 HOLLY AVE, DARIEN, IL 60561-3516
(630) 347-0526
Mailing address
1801 HOLLY AVE, DARIEN, IL 60561-3516
(630) 347-0526
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
443568
IL
Other
Enumeration date
05/20/2015
Last updated
05/20/2015
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