Individual provider · Type 1 NPI

Shane Caudill

Student in an Organized Health Care Education/Training Program · Belleville, IL

NPI number 1073900650 Active

Practice location

2600 W Main St
Belleville, IL 62226-6651

Call (618) 239-6109 Map

Mailing address

504 Timothy Ln
Carterville, IL 62918-5045

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1073900650

Shane Caudill's National Provider Identifier is 1073900650, issued on Apr 21, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Belleville, IL. The record was last updated on Apr 21, 2015.