Individual
JOSHUA SCHUPBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
223 E MAIN ST, PRINCEVILLE, IL 61559-9654
(309) 385-4371
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0001
(309) 672-4809
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03611170901
—
IL
01
—
097887
HEALTH ALLIANCE
IL
01
—
36111709
BCBS
IL
01
—
472317
HEALTHLINK
IL
01
—
7215059
BCBS PPO
IL
01
—
IL01W9
JOHN DEERE
IL
01
—
P00197242
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
02/05/2008
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