Individual
SHANNON WITTEL KUBIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 N RANDALL RD STE 400, ELGIN, IL 60123-7805
(847) 381-8899
Mailing address
1600 N RANDALL RD STE 400, ELGIN, IL 60123-7805
(847) 381-8899
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.009359
IL
Other
Enumeration date
09/26/2022
Last updated
12/26/2024
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