Provider Demographics
NPI:1285815969
Name:MCELROY, SHELLY M (DT)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:M
Last Name:MCELROY
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8867 S CORCORAN RD
Mailing Address - Street 2:
Mailing Address - City:HOMETOWN
Mailing Address - State:IL
Mailing Address - Zip Code:60456-1124
Mailing Address - Country:US
Mailing Address - Phone:708-423-6817
Mailing Address - Fax:708-423-6817
Practice Address - Street 1:8867 S CORCORAN RD
Practice Address - Street 2:
Practice Address - City:HOMETOWN
Practice Address - State:IL
Practice Address - Zip Code:60456-1124
Practice Address - Country:US
Practice Address - Phone:708-423-6817
Practice Address - Fax:708-423-6817
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist