Individual
MICHAEL F. SHEKLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2805 N KNOXVILLE AVE, PEORIA, IL 61604-2869
(309) 624-9400
(309) 624-2280
Mailing address
2805 N KNOXVILLE AVE, PEORIA, IL 61604-2869
(309) 624-9400
(309) 624-2280
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-062205
IL
207RG0100X
Gastroenterology Physician
Primary
036-062205
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062205
—
IL
Enumeration date
10/15/2006
Last updated
01/10/2012
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