Shores, Annette V

Shores, Annette V is an individual health care provider with primary practice located at 2 Good Samaritan Way Suite 235, Mount Vernon IL 62864-2408. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Shores, Annette V can be contacted via phone (618) 899-3980.

Contact Information

Primary practice address
2 Good Samaritan Way Suite 235 Mount Vernon IL 62864-2408
Phone: (618) 899-3980
Fax: (618) 899-4793
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036093049 Illinois

Profile Details

NPI number 1912903857
LBN Legal business name Shores, Annette V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated Jan 8th, 2014 - about 10 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 1912903857 NPPES
Illinois MEDICAID 036093049

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