Provider Demographics
NPI:1801980826
Name:SHONKWILER, STEVEN D (RNFA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:SHONKWILER
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 NEWMAN ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61448-1435
Mailing Address - Country:US
Mailing Address - Phone:309-368-3395
Mailing Address - Fax:309-289-8661
Practice Address - Street 1:513 NEWMAN ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IL
Practice Address - Zip Code:61448
Practice Address - Country:US
Practice Address - Phone:309-368-3395
Practice Address - Fax:309-289-8661
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-239854207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
4815127OtherBC/BS