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Shannon Wyatt, ATC
NPI 1992923585 · on the registry since 2007 · sole proprietor
Practice
- Address
- 1145 N Harlem Ave
Oak Park, IL 60302 - Phone
- (708) 386-2086
- Organisation at this address
- Athletico Ltd
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 26
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois