Provider Demographics
NPI:1942069471
Name:PEARSON, SHELDON RAY
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:RAY
Last Name:PEARSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3154 W DAKOTA ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-5208
Mailing Address - Country:US
Mailing Address - Phone:414-334-9254
Mailing Address - Fax:
Practice Address - Street 1:28100 TORCH PKWY STE 600
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-4030
Practice Address - Country:US
Practice Address - Phone:630-413-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist