person
Dr. Roger Sebastian Shinnerl, MD
Vascular Surgery Physician in Carbondale, Illinois
NPI 1760684765

Roger Sebastian Shinnerl is a Vascular Surgery Physician based in Carbondale, IL and is specialized in Vascular Surgery. Roger Sebastian Shinnerl practices in Carbondale, IL and has the professional credentials of MD. The NPI Number for Roger Sebastian Shinnerl is 1760684765 and holds a License No. 036166938 (Illinois).

The current practice location address for Roger Sebastian Shinnerl is 305 W Jackson St Ste 206, Carbondale, IL and can be reached out via phone at 618-457-3006.

Location: 305 W Jackson St Ste 206, Carbondale, IL, 62902-3988
person
Provider Profile Details
NPI Number
1760684765
Provider Name
Roger Sebastian Shinnerl
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
305 W Jackson St Ste 206, Carbondale, IL, 62902-3988
Phone Number
618-457-3006
Fax Number
Provider Enumeration Date
06/01/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7100035620 05 KY
00001666778 01 IN BCBS
01063822A 01 IN STATE LICENSE
01063822B 01 IN STATE CSR
300063165 05 IN
institution
Provider Business Practice Location Address Details
Address
305 W Jackson St Ste 206
City
State
Zip
62901-1474
Phone Number
618-457-3006
Fax Number
person
Provider Business Mailing Address Details
Address
305 W Jackson St Ste 206
City
State
Zip
62901-1474
Phone Number
618-457-3006
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
License No.
036166938 (Illinois)
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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