Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shaun Michael Rudicil

Individual provider Physician Assistant · NPI 1770782062

Shaun Michael Rudicil is a Physician Assistant in Champaign, Illinois. Qualified in 2007, 19 years ago. Practices with Gibson Community Hospital Association, a 159-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
19
Licensed in
IL
In the registry since
2007
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Practice location Address checks out

3101 Fields South Dr
Champaign, IL 61822-3743
Phone: (217) 366-1237
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 501a S Towanda Barnes Rd Ste 2, Bloomington, IL 61705-4031 — (309) 612-9002

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085002994 (IL)

Record details

NPI number1770782062
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 16, 2007
Last updated in NPPESOctober 2, 2025
Certification dateOctober 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Gibson Community Hospital Association — 159 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Champaign