Individual
DEAN P SHOENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1665 SOUTH ST, GENEVA, IL 60134-2542
(630) 208-7874
(630) 208-7880
Mailing address
1665 SOUTH ST, GENEVA, IL 60134-2542
(630) 208-7874
(630) 208-7880
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036099967
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036099967
—
IL
01
—
206147
MEDICARE PTAN GROUP
IL
01
—
F400118964
MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
06/16/2005
Last updated
05/02/2014
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