Provider Demographics
NPI:1053499012
Name:VELTMAN, SHANNON HZ (PA-C)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:HZ
Last Name:VELTMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:H
Other - Last Name:ZILLIGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:880 W CENTRAL RD STE 5000
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2355
Mailing Address - Country:US
Mailing Address - Phone:847-618-3800
Mailing Address - Fax:847-618-3809
Practice Address - Street 1:880 W CENTRAL RD STE 5000
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2355
Practice Address - Country:US
Practice Address - Phone:847-618-3800
Practice Address - Fax:847-618-3809
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-002305363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL001619727OtherBCBS OF ILLINOIS
IL085002305OtherSTATE LICENSE
IL001619727OtherBCBS OF ILLINOIS