Individual
THOMAS J SHULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
444 ROXBURY RD, ROCKFORD, IL 61107-5059
(815) 227-5600
(815) 227-9242
Mailing address
444 ROXBURY RD, ROCKFORD, IL 61107-5059
(815) 227-5600
(815) 227-9242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036074760
IL
2080P0202X
Pediatric Cardiology Physician
Primary
036-074760
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036074760
—
IL
Enumeration date
06/13/2005
Last updated
02/23/2016
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