Provider Demographics
NPI:1003352139
Name:SHINE FUNCTIONAL HEALTH, PLLC
Entity Type:Organization
Organization Name:SHINE FUNCTIONAL HEALTH, PLLC
Other - Org Name:SHINE FUNCTIONAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:E
Authorized Official - Last Name:LECHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:224-345-2532
Mailing Address - Street 1:3233 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1557
Mailing Address - Country:US
Mailing Address - Phone:224-345-2532
Mailing Address - Fax:
Practice Address - Street 1:3233 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 302
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1557
Practice Address - Country:US
Practice Address - Phone:224-345-2532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-111919207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty