Healthcare Provider Details

I. General information

NPI: 1912832775
Provider Name (Legal Business Name): THOMAS MCSHEEHY MSW, LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 CLYDE AVE APT 3E
EVANSTON IL
60202-4011
US

IV. Provider business mailing address

131 CLYDE AVE APT 3E
EVANSTON IL
60202-4011
US

V. Phone/Fax

Practice location:
  • Phone: 720-369-3000
  • Fax:
Mailing address:
  • Phone: 720-369-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150-009367
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: