Individual
SHANE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5375
(708) 684-3776
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5375
(708) 684-3776
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-174202
IL
Other
Enumeration date
03/28/2022
Last updated
06/24/2025
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