SHANNON DIANE WYATT (NPI# 1992923585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992923585 |
Entity Type | Individual |
Full Name | SHANNON DIANE WYATT |
Credential | ATC |
Practice Address |
1145 N Harlem Ave Oak Park IL 60302-1529 |
Mailing Address |
1418 W Olive Ave Chicago IL 60660-4229 |
Practice Telephone | 7083862086 |
Mailing Telephone | 7738052119 |
Enumeration Date | 2007-04-22 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992151203 | Shannon Wyatt | Specialist | 400 Commerce Cir, H, Yorktown, VA 23693-4322 | 2016-05-05 |
1962050161 | Shannon Wyatt | Occupational Therapist | 3609 Sw Durham Dr, Durham, NC 27707-6507 | 2019-08-30 |
1285112755 | Shannon Wyatt | Nurse Practitioner | 10700 N Rodney Parham Rd Ste C11, Little Rock, AR 72212-4110 | 2018-08-06 |
1184770026 | Shannon M Wyatt | Counselor | 245 Fountain Ct Ste 225, Lexington, KY 40509-1888 | 2007-01-25 |
Street Address |
1145 N HARLEM AVE |
City | OAK PARK |
State | IL |
Zip Code | 60302-1529 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952391880 | Tanya Lynn Yaskoff | Specialist/Technologist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2005-10-23 |
1255982146 | Khattab Iwainat | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2019-09-23 |
1124587530 | Nicholas D Lempke | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2019-03-15 |
1013497197 | Daniel P Foley | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2018-08-17 |
1871083717 | Patricia J Starkey | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302 | 2018-05-16 |
1346755725 | Sean T Capili | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2017-12-07 |
1730698630 | Benjamin T Mueller | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2017-09-22 |
1730612391 | John Hurley | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2017-04-10 |
1417401571 | Nazneen Kaka | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2016-08-06 |
1700236254 | Joseph Klis | Physical Therapist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2016-06-15 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306473244 | Tasha Kimberly Young | Counselor | 1216 N Austin Bvld, Oak Park, IL 60302 | 2020-03-23 |
1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
1326603887 | Right Choice Therapy LLC | Social Worker | 428 S. Scoville Avenue, Rear 1b, Oak Park, IL 60302 | 2019-05-09 |
1407328941 | Arundathi Bannur Suresh | Occupational Therapist | 3 Erie Court, West Suburban Medical Center, Oak Park, IL 60302 | 2018-12-21 |
1427537455 | Shannon Vogel | Occupational Therapist | 405 Home Ave Apt 207, Oak Park, IL 60302 | 2018-08-10 |
1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
1649783143 | Mary Joyce Arenas Lagatao | Nurse Practitioner | 101 Madison St, 3rd Floor, Oak Park, IL 60302 | 2017-11-07 |
1427578251 | Amanda Lam | Behavior Technician | 721 South Blvd., Suite 210, Oak Park, IL 60302 | 2017-06-22 |
1649790577 | Samantha Lotti | Acupuncturist | 1119 Pleasant St, Oak Park, IL 60302 | 2017-06-21 |
1770010480 | Robert Smith IIi | Behavior Technician | 412a S. Taylor Ave, Oak Park, IL 60302 | 2017-05-12 |
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Taxonomy Code | 2255A2300X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Specialist/Technologist |
Specialization | Athletic Trainer |
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801493697 | Janelle Dorsey | Specialist/Technologist | 24311 Ithaca St, Oak Park, MI 48237-1788 | 2020-10-05 |
1588026975 | Kelly Therese Smith | Specialist/Technologist | 344 S Maple Ave #2a, Oak Park, IL 60302 | 2016-03-24 |
1700153426 | David Heidloff | Specialist/Technologist | 126 N Elmwood Ave, Apt C3, Oak Park, IL 60302-2628 | 2011-11-23 |
1114044948 | Holly J Odean | Specialist/Technologist | 1 Erie Ct Ste 7120, Oak Park, IL 60302-2510 | 2007-03-25 |
1396736369 | Anthony John Mccormick | Specialist/Technologist | 824 Wisconsin Ave, Oak Park, IL 60304-1044 | 2005-10-31 |
1952391880 | Tanya Lynn Yaskoff | Specialist/Technologist | 1145 N Harlem Ave, Oak Park, IL 60302-1529 | 2005-10-23 |
1558335489 | Michael Barnish | Specialist/Technologist | 1 Erie Ct, Suite 7140, Oak Park, IL 60302-2566 | 2006-02-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538771076 | Stacey Weathers-cannon | Specialist/Technologist | 650 Ingraham Ave, Calumet City, IL 60409-4236 | 2020-08-17 |
1104438621 | Abril Malagon | Specialist/Technologist | 1 S Greenwood Ave, Palatine, IL 60074-6328 | 2020-08-17 |
1265050678 | Megan Elsbree | Specialist/Technologist | 11819 Deacon Dr, Rockton, IL 61072-9411 | 2020-07-13 |
1013534437 | Nicole Rose Mondelli | Specialist/Technologist | 958 Tallgrass Dr, Bartlett, IL 60103-5071 | 2020-07-01 |
1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
1164047239 | Madison Stagman | Specialist/Technologist | 280 Douglas Ave Apt 4, Mascoutah, IL 62258-2963 | 2020-06-14 |
1588286272 | Sarah Wegrzyn | Specialist/Technologist | 3040 S Wabash Ave, Chicago, IL 60616-3474 | 2020-05-15 |
1336761386 | Christine Louise Shebelski | Specialist/Technologist | 15203 Pulaski Rd, Midlothian, IL 60445-3755 | 2020-05-13 |
1386266633 | Kathryn Riordan | Specialist/Technologist | 221 Triton Ln, Naperville, IL 60540-7926 | 2020-05-09 |
1487276747 | Vianey Hernandez-ramirez | Specialist/Technologist | 4115 Howard St, Skokie, IL 60076-3749 | 2020-05-09 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.