Individual
SHAUNA WITTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3440 OHIO ST, GREAT LAKES, IL 60088-3155
(847) 688-2100
Mailing address
3440 OHIO ST, GREAT LAKES, IL 60088-3155
(847) 688-2100
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.16199
IL
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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