Provider Demographics
NPI:1891183091
Name:LEHMAN, SHAUNNA
Entity Type:Individual
Prefix:
First Name:SHAUNNA
Middle Name:
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAUNNA
Other - Middle Name:
Other - Last Name:HEIDEGGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:8936 SOUTH SHELBY, STE A-1
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-6264
Practice Address - Country:US
Practice Address - Phone:317-888-3838
Practice Address - Fax:317-865-7262
Is Sole Proprietor?:No
Enumeration Date:2014-12-23
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005114A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201205280Medicaid
IN555850050Medicare PIN