Provider Demographics
NPI:1013155381
Name:GUNEY, SHAWNA JO (MMS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:JO
Last Name:GUNEY
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:MS
Other - First Name:SHAWNA
Other - Middle Name:JO
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5340 LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1846
Mailing Address - Country:US
Mailing Address - Phone:214-592-3073
Mailing Address - Fax:
Practice Address - Street 1:5340 LAWN AVE
Practice Address - Street 2:
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1846
Practice Address - Country:US
Practice Address - Phone:214-592-3073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085008895363A00000X
390200000X
TXPA6078363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program