MICHAEL SHANE PAMPUCH NPI 1063156586

NPI Information

  • NPI: 1063156586
  • Provider Name: MICHAEL SHANE PAMPUCH
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • Address: 2250 E STELLON ST
    DIAMOND, IL
    ZIP 60416
  • Phone: (815) 662-7701

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NPI Details

Michael Shane Pampuch is a student in an organized health care education training program in Diamond, IL. The provider is 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. Michael Shane Pampuch NPI is 1063156586. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2250 E STELLON ST
DIAMOND, IL
ZIP 60416-749
Phone: (815) 662-7701

The enumeration date for this NPI number is 4/21/2022 and was last updated on 4/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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