Provider Demographics
NPI:1245886191
Name:ONEILL, CAROLINE MOORE
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:MOORE
Last Name:ONEILL
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 1:10163 POTTER RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1546
Mailing Address - Country:US
Mailing Address - Phone:773-774-2029
Mailing Address - Fax:
Practice Address - Street 1:10163 POTTER RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1546
Practice Address - Country:US
Practice Address - Phone:773-774-2029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider