Provider Demographics
NPI:1568499341
Name:OSHAUGHNESSY, SHEILA K (OD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:K
Last Name:OSHAUGHNESSY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1724
Mailing Address - Country:US
Mailing Address - Phone:630-969-2020
Mailing Address - Fax:630-969-1415
Practice Address - Street 1:4760 MAIN ST
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1724
Practice Address - Country:US
Practice Address - Phone:630-969-2020
Practice Address - Fax:630-969-1415
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL346001133152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
P15856Medicare PIN