Individual
SHAWN M BRETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
106 S EMERSON ST, MOUNT PROSPECT, IL 60056-3220
(847) 368-1234
(847) 603-7478
Mailing address
106 S EMERSON ST, MOUNT PROSPECT, IL 60056-3220
(847) 368-1234
(847) 603-7478
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038008779
IL
111NI0900X
Internist Chiropractor
Primary
038.008779
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635079
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/31/2005
Last updated
01/23/2014
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