Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 016-004714 | IL |
N | 213ES0131X | Foot Surgery | 070009324A | IN |
NPI | 1083628101 |
---|---|
Provider Name | Julia Eve Shauger |
First Address | Homewood, IL 60430-1812 |
Second Address | Homewood, IL 60430-1812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 05/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1632534 | BCBS (01) | IL |
4618176 | DEPT OF LABOR (01) | IL |
U48192 | (02) | IL |