Individual
SHANE STEPHEN HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1860 W WINCHESTER RD STE 106, LIBERTYVILLE, IL 60048-5312
(847) 816-6335
Mailing address
1860 W WINCHESTER RD STE 106, LIBERTYVILLE, IL 60048-5312
(847) 816-6335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.009911
IL
363A00000X
Physician Assistant
8293
WI
Other
Enumeration date
03/29/2023
Last updated
09/18/2025
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