Healthcare Provider Details

I. General information

NPI: 1902025737
Provider Name (Legal Business Name): MAUREEN BLANCHFIELD-OKEEFE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9634 S PULASKI RD
OAK LAWN IL
60453-3391
US

IV. Provider business mailing address

PO BOX 2427
ORLAND PARK IL
60462-1089
US

V. Phone/Fax

Practice location:
  • Phone: 708-423-4800
  • Fax: 708-423-4843
Mailing address:
  • Phone: 815-834-2400
  • Fax: 815-834-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070-010241
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: