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Individual

DR. JOHN EDWARD SHEARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
288 N PARK ST, DECATUR, IL 62523-1306
(217) 422-3881
Mailing address
7720 N CRESTLINE DR, PEORIA, IL 61615-1907
(309) 693-9540

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002299B
IN
152W00000X
Optometrist
OD001172
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046009270
IL
Enumeration date
11/18/2005
Last updated
06/23/2010
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