Individual
DR. JOHN ANDREW SHOUDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2070 W ILES AVE, SPRINGFIELD, IL 62704-4174
(217) 698-6228
(217) 698-7241
Mailing address
747 N RUTLEDGE ST, SPRINGFIELD, IL 62702-6700
(217) 652-3816
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
IL016004443
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016-004443
—
IL
Enumeration date
07/13/2005
Last updated
09/27/2023
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