Most Relevant Information
Provider Data
| NPI Number: | 1003228263 |
| Provider Name: | SHANNON PATRICIA GENGENBACHER PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 070019069 |
Most Important Dates
| Enumeration Date: | 05/22/2014 |
| Last Updated: | 03/17/2018 |
Provider Practice Location
14731 S VAN DYKE RD
PLAINFIELD
IL
605443185
Practice Location Phone/Fax
| Phone: | 8152673196 |
| Fax: |
Provider Mailing Location
3614 LANDINGS RD
JOLIET
IL
604311597
Provider Mailing Phone/Fax
| Phone: | 6104570052 |
| Fax: |