Individual
SHANNON ROSENBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
657 PASADENA AVE, BEECHER, IL 60401-3611
(815) 671-9279
Mailing address
CARDIOTHORACIC AND VASCULAR SURGICAL ASSOCIATES SC, 4400 W 95TH STREET SUITE 308, OAK LAWN, IL 60453-2660
(708) 346-4040
(708) 346-3287
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2021
Last updated
10/21/2021
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