Individual
DANIEL SHEKLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2499
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-108944
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108944
—
IL
Enumeration date
12/26/2006
Last updated
07/23/2021
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