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Michael Shane Pampuch
Student in an Organized Health Care Education/Training Program in Diamond, Illinois
NPI 1063156586

Michael Shane Pampuch is a Student in an Organized Health Care Education/Training Program based in Diamond, IL. Michael Shane Pampuch practices in Diamond, IL. The NPI Number for Michael Shane Pampuch is 1063156586 and holds a License No. (Illinois).

The current practice location address for Michael Shane Pampuch is 2250 E Stellon St, Diamond, IL and can be reached out via phone at 815-662-7701.

Location: 2250 E Stellon St, Diamond, IL, 60416-9749
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063156586
Provider Name
Michael Shane Pampuch
Credential
Provider Entity Type
Individual
Gender
Male
Address
2250 E Stellon St, Diamond, IL, 60416-9749
Phone Number
815-662-7701
Fax Number
Provider Enumeration Date
04/21/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2250 E Stellon St
City
Diamond
State
Illinois
Zip
60416-9749
Phone Number
815-662-7701
Fax Number
person
Provider Business Mailing Address Details
Address
2250 E Stellon St
City
Diamond
State
Illinois
Zip
60416-9749
Phone Number
815-662-7701
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
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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