Provider Demographics
NPI:1245781558
Name:KRIPPINGER, SHANNON M (PA-C)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:M
Last Name:KRIPPINGER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:130 S MAIN ST STE 304
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2670
Mailing Address - Country:US
Mailing Address - Phone:630-646-7000
Mailing Address - Fax:630-548-1563
Practice Address - Street 1:327 GUNDERSEN DR
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2402
Practice Address - Country:US
Practice Address - Phone:630-665-9155
Practice Address - Fax:630-665-9770
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2021-01-27
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Provider Licenses
StateLicense IDTaxonomies
IL363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical