Provider Demographics
NPI:1265626709
Name:SHEEHY, WILLIAM T
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:T
Last Name:SHEEHY
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:T
Other - Last Name:SHEEHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2000 LARKIN AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4404
Mailing Address - Country:US
Mailing Address - Phone:847-695-6440
Mailing Address - Fax:847-695-6298
Practice Address - Street 1:2000 LARKIN AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4404
Practice Address - Country:US
Practice Address - Phone:847-695-6440
Practice Address - Fax:847-695-6298
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice