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Individual
DR. JOHN ROBERT KILLOUGH
Active
Individual
DR. JOHN ROBERT KILLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
16005103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01532005
BLUE CROSS BLUE SHIELD OF
IL
05
—
016005103
—
IL
Enumeration date
10/13/2006
Last updated
07/13/2009
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