Shannon, Kathleen M
Shannon, Kathleen M is an individual health care provider with primary practice located at 600 Highland Ave , Madison WI 53792-0001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Shannon, Kathleen M can be contacted via phone (608) 263-5442.Contact Information
Primary practice address
600 Highland Ave
Madison WI 53792-0001
Phone: (608) 263-5442
Fax: (608) 265-1753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 65479 | Wisconsin |
Profile Details
| NPI number | 1396721767 |
|---|---|
| LBN Legal business name | Shannon, Kathleen M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2005 |
| Last updated | Jan 22nd, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396721767 | NPPES |
| Illinois | MEDICAID | 036066536 | |
| Illinois | Other | 336030775 |
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