Individual
DR. SHANNON EILEEN STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-1000
Mailing address
1727 N HERMITAGE AVE, APT #2, CHICAGO, IL 60622-1411
(708) 363-1328
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125056477
IL
Other
Enumeration date
10/27/2009
Last updated
12/29/2021
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