Provider Demographics
NPI:1023324464
Name:SHAPIRO, LEAH ANN
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:ANN
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7753 VAN BUREN ST
Mailing Address - Street 2:UNIT 407
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-1887
Mailing Address - Country:US
Mailing Address - Phone:708-689-0616
Mailing Address - Fax:708-689-0616
Practice Address - Street 1:1 UNIVERSITY CIR
Practice Address - Street 2:CENTER FOR BEST PRACTICES, WESTERN ILLINOIS UNIVERSITY
Practice Address - City:MACOMB
Practice Address - State:IL
Practice Address - Zip Code:61455-1367
Practice Address - Country:US
Practice Address - Phone:800-701-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist