Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 211.000050 | IL |
NPI | 1053813089 |
---|---|
Provider Name | James Paul Shrader |
First Address | Oakbrook Terrace, IL 60181-3985 |
Second Address | Naperville, IL 60563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2018 |
Last Update Date | 06/03/2018 |