Tim Shannon, PSYD | |
405 Kays Dr Ste C, Normal, IL 61761-1979 | |
(309) 664-3130 | |
(309) 664-3528 |
Full Name | Tim Shannon |
---|---|
Gender | Male |
Speciality | Clinical Psychologist |
Experience | 33 Years |
Location | 405 Kays Dr Ste C, Normal, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407956758 | NPI | - | NPPES |
IL2613 | Other | IL | MEDICARE GROUP PTAN |
DP5951 | Other | RR MEDICARE GROUP | |
P00820811 | Other | RR MEDICARE INDIVIDUAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 071004783 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Osf Multi-specialty Group | 3678889789 | 1552 |
Entity Name | Osf Multi-specialty Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Mailing Address | Practice Location Address |
---|---|
Tim Shannon, PSYD 405 Kays Dr Ste C, Normal, IL 61761-1979 Ph: (309) 664-3130 | Tim Shannon, PSYD 405 Kays Dr Ste C, Normal, IL 61761-1979 Ph: (309) 664-3130 |
Girishkumar Dhorajia, MD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1304 Franklin Ave, Advocate Bromenn Medical Center, Normal, IL 61761 Phone: 309-268-5376 Fax: 309-268-2374 | |
Judy Ronan Woodburn, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 403 W Virginia Ave, Normal, IL 61761 Phone: 309-268-2910 Fax: 309-268-2913 | |
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