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NPI Code Detail

MEDICARE: SHANNON MARIE LAFOND

MEDICARE: SHANNON MARIE LAFOND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1740120757
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MARIE LAFOND
Provider Business Mailing Address
First Line : 820 S WOOD ST STE 100
Second Line : MC 675
City : CHICAGO
State : IL
Zip : 60612-4325
Country : US
Telephone Number : 312-996-2933
Fax Number :
Provider Business Practice Location Address
First Line : 820 S WOOD ST STE 100
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4325
Country : US
Telephone Number : 312-996-2933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 03/30/2026

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Directions to “ SHANNON MARIE LAFOND ” Practice Location

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