Provider Demographics
NPI:1235268921
Name:ANDRESS, SHARI (M ED)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:
Last Name:ANDRESS
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 BRYCE TRL
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-1022
Mailing Address - Country:US
Mailing Address - Phone:847-736-5297
Mailing Address - Fax:
Practice Address - Street 1:564 BRYCE TRL
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-1022
Practice Address - Country:US
Practice Address - Phone:847-736-5297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILSA87930903P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist