Healthcare Provider Details

I. General information

NPI: 1982960639
Provider Name (Legal Business Name): ANNORA MARIE SHEEHAN GAERIG DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNORA MARIE SHEEHAN DVM

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 S MILWAUKEE AVE
WHEELING IL
60090-5021
US

IV. Provider business mailing address

372 S MILWAUKEE AVE
WHEELING IL
60090-5021
US

V. Phone/Fax

Practice location:
  • Phone: 847-215-3933
  • Fax: 847-215-3984
Mailing address:
  • Phone: 847-215-3933
  • Fax: 847-215-3984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number090.010439
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6731
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6901010070
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: