Healthcare Provider Details

I. General information

NPI: 1841581956
Provider Name (Legal Business Name): SHAWNA O'REILLY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHAWNA SUCHECKI D.O.

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 LAKE ZURICH RD
BARRINGTON IL
60010-3141
US

IV. Provider business mailing address

1000 N WESTMORELAND RD
LAKE FOREST IL
60045-1658
US

V. Phone/Fax

Practice location:
  • Phone: 847-381-5599
  • Fax: 847-381-1431
Mailing address:
  • Phone: 847-535-7058
  • Fax: 847-535-7023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number036144273
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084H0002X
TaxonomyHospice and Palliative Medicine (Psychiatry & Neurology) Physician
License Number036144273
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number036144273
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: