Individual
JOHN DUDLEY SHEPHERDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
107 E JEFFERSON ST, MORTON, IL 61550-2001
(309) 266-9711
(309) 266-6322
Mailing address
107 E JEFFERSON ST, MORTON, IL 61550-2001
(309) 266-9711
(309) 266-6322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058746
HEALTH ALLIANCE
IL
01
—
227840
HEALTH LINK
IL
Enumeration date
08/16/2006
Last updated
07/08/2007
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