Provider Demographics
NPI:1750412474
Name:TAYLOR, SHEILA A (PT)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 N CORPORATE CIR
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7822
Mailing Address - Country:US
Mailing Address - Phone:847-223-8001
Mailing Address - Fax:847-986-3580
Practice Address - Street 1:997 N CORPORATE CIR
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7822
Practice Address - Country:US
Practice Address - Phone:847-223-8001
Practice Address - Fax:847-986-3580
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700091022251N0400X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK24799Medicare ID - Type UnspecifiedMEDICARE MEMBER #