Individual
MICHAEL SHEPPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23W632 MAPLE AVE, ROSELLE, IL 60172-2131
(630) 501-8495
Mailing address
23W632 MAPLE AVE, ROSELLE, IL 60172-2131
(630) 501-8495
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
07/03/2015
Last updated
07/03/2015
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