Organization · Type 2 NPI
Lake Shore Ob Gyn of Decatur S C
Specialist · Decatur, IL
NPI number
1700925583
Active
Practice location
741 W Pershing Rd
Decatur, IL 62526-1634
Fax (217) 429-0108
Mailing address
1770 E Lake Shore Dr, Suite 303
Decatur, IL 62521-3832
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | None listed |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
4 other providers at this address
Other specialist providers in Decatur
About NPI 1700925583
Lake Shore Ob Gyn of Decatur S C's National Provider Identifier is 1700925583, issued on Feb 6, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Decatur, IL. The record was last updated on May 13, 2025.