Kopecky, Shannon Lynn

Kopecky, Shannon Lynn is an individual health care provider with primary practice located at 2650 Ridge Ave Anesthesiology, Room 3905, Evanston IL 60201-1718. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Kopecky, Shannon Lynn can be contacted via phone (847) 570-2760.

Contact Information

Primary practice address
2650 Ridge Ave Anesthesiology, Room 3905 Evanston IL 60201-1718
Phone: (847) 570-2760
Fax: (847) 570-2921
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 041-318243 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 75953 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4998 North Carolina

Profile Details

NPI number 1154455962
LBN Legal business name Kopecky, Shannon Lynn
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2007
Last updated Jan 11th, 2024 - about last year

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 1154455962 NPPES
Illinois Other 041-318243 IL STATE LIC

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