Provider Demographics
NPI:1376518894
Name:BIGELOW, SHEILA LYNN (ATC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:LYNN
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17011 S BLACKFOOT DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-4367
Mailing Address - Country:US
Mailing Address - Phone:815-834-0041
Mailing Address - Fax:
Practice Address - Street 1:17837 80TH AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-5023
Practice Address - Country:US
Practice Address - Phone:708-342-2500
Practice Address - Fax:708-342-1454
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer