Provider Demographics
NPI:1366875833
Name:SCONYERS, SHAWNNTANEVIA
Entity type:Individual
Prefix:
First Name:SHAWNNTANEVIA
Middle Name:
Last Name:SCONYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 ABBEY DR
Mailing Address - Street 2:APT 4B
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2581
Mailing Address - Country:US
Mailing Address - Phone:630-229-9587
Mailing Address - Fax:
Practice Address - Street 1:5650 ABBEY DR
Practice Address - Street 2:APT 4B
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-2581
Practice Address - Country:US
Practice Address - Phone:630-229-9587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist