Individual
SHANNON LYN BARTOLUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1909 OGDEN AVE STE A, DOWNERS GROVE, IL 60515-2602
(630) 832-1775
(630) 832-1775
Mailing address
415 ANTHONY ST, GLEN ELLYN, IL 60137-4419
(630) 864-7410
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.004191
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209.004191
IL
Other
Enumeration date
01/19/2011
Last updated
07/15/2024
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