SHANNON DIANE WYATT


Address: 1145 N Harlem Ave, Oak Park, IL 60302-1529
Phone: 7083862086

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).

Provider Overview

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

Taxonomy

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

Other Providers SHANNON WYATT

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

Office Location

Street Address 1145 N HARLEM AVE
City OAK PARK
State IL
Zip Code 60302-1529

Providers in the same location

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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Providers in the same zip code

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 Information

Taxonomy Code 2255A2300X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Specialist/Technologist
Specialization Athletic Trainer

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City OAK PARK
Zip Code 60302

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Dataset Information

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.

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