Wyatt, Shannon Diane

Wyatt, Shannon Diane is an sole proprietor health care provider with primary practice located at 1145 N Harlem Ave , Oak Park IL 60302-1529. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Wyatt, Shannon Diane can be contacted via phone (708) 386-2086.

Contact Information

Primary practice address
1145 N Harlem Ave Oak Park IL 60302-1529
Phone: (708) 386-2086
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X Illinois

Profile Details

NPI number 1992923585
LBN Legal business name Wyatt, Shannon Diane
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 22nd, 2007
Last updated Jul 8th, 2007 - about 17 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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