Individual
DR. DOUGLAS SHUMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2929 MCFARLAND RD, ROCKFORD, IL 61107-6809
(815) 654-2020
Mailing address
2421 OXFORD ST, ROCKFORD, IL 61103-4166
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
046-8317
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203372
MEDICARE ID
IL
01
—
36-4325927
TAX ID
IL
Enumeration date
03/19/2007
Last updated
12/11/2008
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