Mr Shannon Lane, LCSW, CADC is a
Social Worker - Clinical based in Bolingbrook, Illinois. Mr Shannon Lane is licensed to practice in Illinois (license number 149.015175) and his current practice location is
682 W Boughton Rd Ste B, Bolingbrook, Illinois. He can be reached at his office (for appointments etc.) via phone at
(630) 945-0429.
NPI number for Mr Shannon Lane is 1215278304 and his current mailing address is 682 W Boughton Rd Ste B, Bolingbrook, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1215278304.
Healthcare Provider's Profile
Full Name | Mr Shannon Lane |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 682 W Boughton Rd Ste B, Bolingbrook, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1215278304
- Provider Enumeration Date: 03/14/2013
- Last Update Date: 08/15/2024
Medical Identifiers
Medical identifiers for Mr Shannon Lane such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215278304 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 28818 (Illinois) | Secondary |
1041C0700X | Social Worker - Clinical | 149.015175 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Shannon Lane is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Shannon Lane, LCSW, CADC 682 W Boughton Rd Ste B, Bolingbrook, IL 60440-2199 Ph: (630) 945-0429 | Mr Shannon Lane, LCSW, CADC 682 W Boughton Rd Ste B, Bolingbrook, IL 60440-2199 Ph: (630) 945-0429 |
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