Provider Demographics
NPI:1053626770
Name:GEIMER ONEIL, MARY A (PHYSICAL THEREPIST)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:GEIMER ONEIL
Suffix:
Gender:F
Credentials:PHYSICAL THEREPIST
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:GEIMER ONEIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THEREPIST
Mailing Address - Street 1:4807 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2501
Mailing Address - Country:US
Mailing Address - Phone:708-599-1983
Mailing Address - Fax:708-599-7420
Practice Address - Street 1:4807 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2501
Practice Address - Country:US
Practice Address - Phone:708-599-1983
Practice Address - Fax:708-599-7420
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.005036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist