STEPHEN & FRED SHRADER PTR; NPI #1366599854

Contact Information

STEPHEN & FRED SHRADER PTR

204 N LOCUST ST
ARCOLA, IL 61910-1407

Phone: 217-268-4848
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulance	341600000X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for STEPHEN & FRED SHRADER PTR

NPI # 1366599854

LBN Legal business name STEPHEN & FRED SHRADER PTR

Authorized official CONNIE SHRADER - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/05/2007

Last updated 01/24/2012 - About 14 years ago

Identifiers

IL	License #	670002
IL	Other	2190002	BCBS NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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