Provider Demographics
NPI:1629458575
Name:MCNEAL, SHARON N (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:N
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 HARBOR AVE
Mailing Address - Street 2:APT. 2
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-1631
Mailing Address - Country:US
Mailing Address - Phone:312-547-9514
Mailing Address - Fax:708-360-3257
Practice Address - Street 1:1646 HARBOR AVE
Practice Address - Street 2:APT. 2
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-1631
Practice Address - Country:US
Practice Address - Phone:312-547-9514
Practice Address - Fax:708-360-3257
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL041335808163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse