Provider Demographics
NPI:1093886129
Name:O'NEILL, TOMI DONNELL (MS ATC)
Entity Type:Individual
Prefix:MRS
First Name:TOMI
Middle Name:DONNELL
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MS ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 STONEWATER LN
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8277
Mailing Address - Country:US
Mailing Address - Phone:630-636-2256
Mailing Address - Fax:
Practice Address - Street 1:1525 HARVEY RD
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8290
Practice Address - Country:US
Practice Address - Phone:630-636-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL960011412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer