Provider Demographics
NPI:1083738389
Name:KALEY, SHARON LORRAINE (OTR)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LORRAINE
Last Name:KALEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 N SANDBURG TER
Mailing Address - Street 2:906
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1566
Mailing Address - Country:US
Mailing Address - Phone:312-307-4594
Mailing Address - Fax:312-751-2563
Practice Address - Street 1:1455 N SANDBURG TER
Practice Address - Street 2:906
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-1566
Practice Address - Country:US
Practice Address - Phone:312-307-4594
Practice Address - Fax:312-751-2563
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL56002175225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics