Provider Demographics
NPI:1093092793
Name:SHELDON, DAVID JOSEPH (LICENSED SPEECH-LANG)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:SHELDON
Suffix:
Gender:M
Credentials:LICENSED SPEECH-LANG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BROOK PARK LN
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-2641
Mailing Address - Country:US
Mailing Address - Phone:708-503-8243
Mailing Address - Fax:
Practice Address - Street 1:51 BROOK PARK LN
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-2641
Practice Address - Country:US
Practice Address - Phone:708-503-8243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.002168235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist