Individual
DR. SHANE MYLES YORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2111 MIDLANDS CT, SYCAMORE, IL 60178-3125
(815) 758-0000
(815) 756-7130
Mailing address
2111 MIDLANDS CT, SYCAMORE, IL 60178-3125
(815) 758-0000
(815) 756-7130
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-005300
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
P-189
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005300
—
IL
01
—
03595800001
DMERC IDENTIFIER
IL
01
—
119909
HEALTH ALLIANCE IDENTIFIE
IL
01
—
1915167
BLUECROSSBLUE SHIELD
IL
Enumeration date
05/08/2006
Last updated
12/01/2020
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