Individual
DR. MICHAEL AUBREY SHANHOLTZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
500 W MAPLE ST, SUITE 206, NEW LENOX, IL 60451-2908
(815) 485-3369
(815) 485-4925
Mailing address
1514 EAGLE VISTA DR, NEW LENOX, IL 60451-2313
(815) 485-5862
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003108
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60010777
BLUE CROSS/SECOND OFFICE
IL
01
—
60201194
BLUE CROSS/PRIMARY OFFICE
IL
Enumeration date
09/01/2006
Last updated
06/18/2013
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