Individual
BART RANDALL SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2501
(217) 838-3311
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2501
(217) 838-3311
(217) 383-3265
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209003210
IL
Other
Enumeration date
10/23/2007
Last updated
09/04/2025
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