Provider Demographics
NPI:1841408101
Name:MCCOY, JEANNE O'NEIL (PT, MS, NCS)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:O'NEIL
Last Name:MCCOY
Suffix:
Gender:F
Credentials:PT, MS, NCS
Other - Prefix:MISS
Other - First Name:JEANNE
Other - Middle Name:MARGARET
Other - Last Name:O'NEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:805 S HUMPHREY AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1718
Mailing Address - Country:US
Mailing Address - Phone:708-386-7489
Mailing Address - Fax:
Practice Address - Street 1:1919 W TAYLOR ST
Practice Address - Street 2:UIC, DEPT OF PT, CAHS, 4TH FLR, MC 898
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7246
Practice Address - Country:US
Practice Address - Phone:312-996-7783
Practice Address - Fax:312-996-4583
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4949225100000X
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist