Mrs Mary Ann Shannon, RD LD | |
1801 Holly Ave, Darien, IL 60561-3516 | |
(630) 347-0526 | |
Not Available |
Full Name | Mrs Mary Ann Shannon |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 1801 Holly Ave, Darien, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245619493 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 443568 (Illinois) | Primary |
Provider Name | Ad Medical Supply Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1629015904 PECOS PAC ID: 0648173120 Enrollment ID: O20131022001869 |
Mailing Address | Practice Location Address |
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Mrs Mary Ann Shannon, RD LD 1801 Holly Ave, Darien, IL 60561-3516 Ph: (630) 347-0526 | Mrs Mary Ann Shannon, RD LD 1801 Holly Ave, Darien, IL 60561-3516 Ph: (630) 347-0526 |
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