Provider Demographics
NPI:1851798771
Name:RODEE, SHANELLE FAYE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SHANELLE
Middle Name:FAYE
Last Name:RODEE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 KENSIGNTON ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAKBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523
Mailing Address - Country:US
Mailing Address - Phone:630-338-7770
Mailing Address - Fax:
Practice Address - Street 1:1420 KENSINGTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2143
Practice Address - Country:US
Practice Address - Phone:630-338-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL05010619174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05010619OtherOCCUPATIONAL THERAPIST