Provider Demographics
NPI:1851862817
Name:TROCKI, SHANNON SUNSHINE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:SUNSHINE
Last Name:TROCKI
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 DOTY RD STE B
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-7530
Mailing Address - Country:US
Mailing Address - Phone:815-356-2323
Mailing Address - Fax:815-206-2823
Practice Address - Street 1:3707 DOTY RD STE B
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-7530
Practice Address - Country:US
Practice Address - Phone:815-356-2323
Practice Address - Fax:815-206-2823
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.016920363LF0000X
IL209016920363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily