Fancher, Shane R
Fancher, Shane R is an individual health care provider with primary practice located at 1800 E Lake Shore Dr , Decatur IL 62521-3810. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Fancher, Shane R can be contacted via phone (217) 464-2729.Contact Information
Primary practice address
1800 E Lake Shore Dr
Decatur IL 62521-3810
Phone: (217) 464-2729
Fax: (217) 464-1693
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 24559 | South Carolina |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | ME93432 | Florida |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036-094339 | Illinois |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 24559 | South Carolina |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 036-094339 | Illinois |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 036-094339 | Illinois |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ME93432 | Florida |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 24559 | South Carolina |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 036-094339 | Illinois |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | ME93432 | Florida |
Profile Details
| NPI number | 1427055433 |
|---|---|
| LBN Legal business name | Fancher, Shane R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2005 |
| Last updated | Aug 17th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427055433 | NPPES |
| Illinois | Other | 336055454 | BCBS |
| Illinois | MEDICAID | 036094339 | BCBS |
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