Individual
SHALLISE D SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3044 183RD ST, LANSING, IL 60438-3010
(708) 632-6863
(773) 783-2357
Mailing address
3044 183RD ST, LANSING, IL 60438-3010
(708) 632-6863
(773) 783-2357
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
03/09/2026
Last updated
05/08/2026
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