Provider Demographics
NPI:1336911890
Name:SHILLIG, WILLIAM
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:SHILLIG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16800 CHUCHUPATE TRL
Mailing Address - Street 2:
Mailing Address - City:FRAZIER PARK
Mailing Address - State:CA
Mailing Address - Zip Code:93225-9331
Mailing Address - Country:US
Mailing Address - Phone:661-289-0409
Mailing Address - Fax:
Practice Address - Street 1:16800 CHUCHUPATE TRL
Practice Address - Street 2:
Practice Address - City:FRAZIER PARK
Practice Address - State:CA
Practice Address - Zip Code:93225-9331
Practice Address - Country:US
Practice Address - Phone:661-289-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide