Individual
MRS. SHANNON L TRUNK - BROKOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 S KENNEDY DR, STE 900, BRADLEY, IL 60915-2682
(815) 932-3132
(815) 932-2397
Mailing address
400 S KENNEDY DR, STE 900, BRADLEY, IL 60915-2682
(815) 937-0933
(815) 932-2397
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IL
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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