Provider Demographics
NPI:1578630950
Name:O'SHEA-KINSLEY, THERESE (MS)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:O'SHEA-KINSLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 PARKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4930
Mailing Address - Country:US
Mailing Address - Phone:847-657-0211
Mailing Address - Fax:847-657-0289
Practice Address - Street 1:26 PARKVIEW RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-4930
Practice Address - Country:US
Practice Address - Phone:847-657-0211
Practice Address - Fax:847-657-0289
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist