Individual
DR. KATHLEEN M SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-5442
(608) 265-1753
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
65479
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036066536
—
IL
01
—
336030775
IL DEPT OF PROF REG
IL
Enumeration date
12/19/2005
Last updated
01/22/2021
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