Provider Demographics
NPI:1720364102
Name:O'ROURKE, SHEILA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21027 LAKEWOODS LN
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-0606
Mailing Address - Country:US
Mailing Address - Phone:708-941-7626
Mailing Address - Fax:
Practice Address - Street 1:100 BEDFORD RD
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-1441
Practice Address - Country:US
Practice Address - Phone:815-941-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.291274183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist