Individual
DR. JOHN ROBERT KILLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1301 DEERPATH ROAD, CHARLESTON, IL 61920-8734
(217) 348-3339
(217) 348-3340
Mailing address
1301 DEERPATH ROAD, CHARLESTON, IL 61920-8734
(217) 348-3339
(217) 348-3340
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
16005103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01532005
BLUE CROSS BLUE SHIELD OF
IL
05
—
016005103
—
IL
Enumeration date
10/13/2006
Last updated
07/13/2009
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