Individual
JONATHAN SHANKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2302 MORELAND BLVD, CHAMPAIGN, IL 61822-1398
(217) 398-8464
Mailing address
44 IVANHOE DR, URBANA, IL 61802-1254
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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