Individual
SHANNON GRAUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9505 142ND ST STE 300, ORLAND PARK, IL 60462-4294
(859) 693-0045
Mailing address
9125 S 54TH AVE, OAK LAWN, IL 60453-1601
(859) 693-0045
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
131.011722
IL
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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