Provider Demographics
NPI:1053442939
Name:SWEENEY, JOHN C (ATC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6449 N NEWGARD AVE # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-5011
Mailing Address - Country:US
Mailing Address - Phone:773-896-8363
Mailing Address - Fax:
Practice Address - Street 1:6449 N NEWGARD AVE # 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-5011
Practice Address - Country:US
Practice Address - Phone:773-896-8363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer