Organization
FREEPORT EAR NOSE & THROAT ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN ALLEN SHIANNA MD (OWNER)
(815) 235-7673
Entity
Organization
Contact information
Practice address
1030 S KUNKLE BLVD, FREEPORT, IL 61032-6914
(815) 235-7673
(815) 235-1310
Mailing address
1030 S KUNKLE BLVD, FREEPORT, IL 61032-6914
(815) 235-7673
(815) 235-1310
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
IL
231H00000X
Audiologist
—
IL
Other
Enumeration date
07/07/2006
Last updated
02/21/2008
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