Provider Demographics
NPI:1497155014
Name:O'CLAIRE, AIMEE O'CLAIRE
Entity Type:Individual
Prefix:
First Name:AIMEE O'CLAIRE
Middle Name:
Last Name:O'CLAIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N ROSELLE RD
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-1592
Mailing Address - Country:US
Mailing Address - Phone:630-529-9189
Mailing Address - Fax:
Practice Address - Street 1:10 N ROSELLE RD
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-1592
Practice Address - Country:US
Practice Address - Phone:630-529-9189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.010667225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist