Healthcare Provider Details

I. General information

NPI: 1366418857
Provider Name (Legal Business Name): SHARON LYNN MCNEELY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6315 W ADDISON ST
CHICAGO IL
60634-4002
US

IV. Provider business mailing address

PO BOX 34421 6315 W. ADDISON STREET
CHICAGO IL
60634-0421
US

V. Phone/Fax

Practice location:
  • Phone: 773-736-2340
  • Fax: 773-736-7033
Mailing address:
  • Phone: 773-736-2340
  • Fax: 773-736-7033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: