Shannon Zofkie, | |
3200 Harlem Ave, Riverside, IL 60546-2012 | |
(630) 728-1744 | |
Not Available |
Full Name | Shannon Zofkie |
---|---|
Gender | Female |
Speciality | Counselor |
Location | 3200 Harlem Ave, Riverside, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164009510 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 178016302 (Illinois) | Primary |
Entity Name | Grace Integrated Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689026148 PECOS PAC ID: 7911272901 Enrollment ID: O20170929003475 |
Mailing Address | Practice Location Address |
---|---|
Shannon Zofkie, 3200 Harlem Ave, Riverside, IL 60546-2012 Ph: (630) 728-1744 | Shannon Zofkie, 3200 Harlem Ave, Riverside, IL 60546-2012 Ph: (630) 728-1744 |
Kevin James Brannick, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3200 Harlem Ave, Riverside, IL 60546 Phone: 708-447-2468 Fax: 708-447-0043 | |
Miss Julia Rita Romero, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7222 W Cermak Rd Ste 500, Riverside, IL 60546 Phone: 773-312-3612 | |
Marie Apke, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 493 Uvedale Rd, Riverside, IL 60546 Phone: 312-848-1590 | |
Jordan Grauman, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3200 Harlem Ave, Riverside, IL 60546 Phone: 630-728-1744 | |
Jenae Angelle Henao, LPC- INTERN Counselor Medicare: Not Enrolled in Medicare Practice Location: 3200 Harlem Ave, Riverside, IL 60546 Phone: 630-728-1744 | |
Matt Meier, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3200 Harlem Ave, Riverside, IL 60546 Phone: 630-728-1744 Fax: 630-988-7029 |