Individual
DR. KIMBERLY A SHUDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
4022 BLACKHAWK RD, ROCK ISLAND, IL 61201-7164
(309) 786-0883
(309) 786-8025
Mailing address
4022 BLACKHAWK RD, ROCK ISLAND, IL 61201-7164
(309) 786-0883
(309) 786-8025
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038006936
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038006936
—
IL
01
—
08128067
BCBS
IL
01
—
350029347
RR MEDICARE
—
Enumeration date
08/09/2005
Last updated
11/12/2013
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