Individual
JORDAN SHERADEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-5241
(217) 464-1647
Mailing address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005628
IL
Other
Enumeration date
02/22/2015
Last updated
02/22/2015
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