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General NPI Number Information
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NPI Number | 1225197486
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Entity Type | Individual
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Provider Name | SHANNON E. ZORN P.A.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 100 VILLAGE GRN STE 120
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3095
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Country | US
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Telephone | 847-634-1766
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Fax |
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 085.003255
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00172000
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License Number State | NJ
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