JOHN SHALLAT

PEORIA, IL
NPI1942381306
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: IL  036-100450)
Enumeration Date2006-10-18
Last Update Date2007-07-08
Business Address
-- JOHN SHALLAT
200 E PENNSYLVANIA AVE
PEORIA, IL 61603-3089
Phone number: 309-655-7990
Mailing Address
-- JOHN SHALLAT
200 E PENNSYLVANIA AVE
PEORIA, IL 61603-3089
Phone number: 309-655-7990
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