Individual
JAMES G. SZUDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2553
(309) 655-2602
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
(309) 655-7869
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-112965
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112965
—
IL
01
—
800810
MEDICARE GROUP NUMBER
IL
Enumeration date
08/20/2006
Last updated
08/28/2007
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