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Individual

SHANNON MARIE POWERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
9650 GROSS POINT RD STE 2900, SKOKIE, IL 60076
(847) 786-6078
(224) 251-2905
Mailing address
9650 GROSS POINT RD STE 2900, SKOKIE, IL 60076-1214
(847) 786-6078
(224) 251-2905

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036145164
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036145164
IL

Other

Enumeration date
06/10/2015
Last updated
10/10/2019
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