Individual
SHAWNA SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1604 VISA DR STE 1, NORMAL, IL 61761-2195
(309) 846-4716
Mailing address
1604 VISA DR STE 1, NORMAL, IL 61761-2195
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
12/29/2010
Last updated
12/29/2010
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