Shane-Gray, Suzan Cathleen

Shane-Gray, Suzan Cathleen is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave Pob 113, Peoria IL 61637-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Shane-Gray, Suzan Cathleen can be contacted via phone (309) 224-8683.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Pob 113 Peoria IL 61637-0001
Phone: (309) 224-8683
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 364SP0200X 209.008562 Illinois

Profile Details

NPI number 1144525452
LBN Legal business name Shane-Gray, Suzan Cathleen
Credentials APN, EDD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2011
Last updated Jan 18th, 2011 - about 13 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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