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Individual

DR. JEFFREY KERSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2000 LAKE AVE, WOODSTOCK, IL 60098
(815) 337-7100
Mailing address
2000 LAKE AVE, WOODSTOCK, IL 60098
(815) 337-7100

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036102674 1
IL
Enumeration date
12/05/2006
Last updated
07/08/2007
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