Individual provider · Type 1 NPI
Shallise D. Shannon
Developmental Therapist · Lansing, IL
Practice location
3044 183rd St
Lansing, IL 60438-3010
Fax (773) 783-2357
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | None listed |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
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About NPI 1558217752
Shallise D. Shannon's National Provider Identifier is 1558217752, issued on Mar 9, 2026. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Lansing, IL. The record was last updated on May 8, 2026.