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Individual

MR. JAMES ALBERT SHUMAKER SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
2430 ILLINOIS STREET, 1007 USS TRANQUILLITY, GREAT LAKES, IL 60088-4209
(847) 688-6755
Mailing address
2430 ILLINOIS STREET, 1007 USS TRANQUILLITY, GREAT LAKES, IL 60088
(847) 688-6755

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
01/25/2012
Last updated
01/25/2012
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