Davis, Shannon Michelle

Davis, Shannon Michelle is an individual health care provider with primary practice located at 15303 S 94Th Ave Ste 110 , Orland Park IL 60462-3825. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Davis, Shannon Michelle can be contacted via phone (800) 991-6117.

Contact Information

Primary practice address
15303 S 94Th Ave Ste 110 Orland Park IL 60462-3825
Phone: (800) 991-6117
Fax: (888) 812-8191
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 05142 Kentucky
Allopathic & Osteopathic Physicians / Surgery 208600000X 34.015496 Ohio
Allopathic & Osteopathic Physicians / Surgery 208600000X 02003690A Indiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 036164424 Illinois

Profile Details

NPI number 1215059506
LBN Legal business name Davis, Shannon Michelle
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2007
Last updated Dec 19th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215059506 NPPES
Ohio MEDICAID 0470386
Ohio MEDICAID 200992420
Ohio MEDICAID 7100787770

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