Provider Demographics
NPI:1457472409
Name:WOOSLEY, EILEEN M (M ED)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:WOOSLEY
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 1:2766 SHELLY LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5883
Mailing Address - Country:US
Mailing Address - Phone:630-624-8737
Mailing Address - Fax:630-499-9384
Practice Address - Street 1:2766 SHELLY LN
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-5883
Practice Address - Country:US
Practice Address - Phone:630-624-8737
Practice Address - Fax:630-499-9384
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist