Individual
JUSTIN LEE SHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9550 W 167TH ST, ORLAND PARK, IL 60467-5561
(708) 873-4500
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006303
IL
363AS0400X
Surgical Physician Assistant
085006303
IL
Other
Enumeration date
08/11/2017
Last updated
09/12/2022
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