Provider Demographics
NPI:1659699478
Name:CAIN SHEBAN, ANNE MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:CAIN SHEBAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W CLEARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4112
Mailing Address - Country:US
Mailing Address - Phone:614-785-9040
Mailing Address - Fax:
Practice Address - Street 1:360 E RANDOLPH ST APT 3802
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7340
Practice Address - Country:US
Practice Address - Phone:614-588-2967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 002616174400000X
IL056.012911225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist