Provider Demographics
NPI:1700032844
Name:O'SHEA, MARGARET MARY
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:O'SHEA
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 1:5201 WALNUT AVE
Mailing Address - Street 2:STE. 4
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4071
Mailing Address - Country:US
Mailing Address - Phone:630-964-4707
Mailing Address - Fax:630-964-4797
Practice Address - Street 1:5201 WALNUT AVE
Practice Address - Street 2:STE. 4
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4071
Practice Address - Country:US
Practice Address - Phone:630-964-4707
Practice Address - Fax:630-964-4797
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.005980225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics