Healthcare Provider Details

I. General information

NPI: 1790600401
Provider Name (Legal Business Name): TEAGAN SHEA O'FLAHERTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 MEETING HOUSE RD STE 4AND5
CHELMSFORD MA
01824-2766
US

IV. Provider business mailing address

8402 CROWN CIR
WILLOW SPRINGS IL
60480-1132
US

V. Phone/Fax

Practice location:
  • Phone: 978-970-2460
  • Fax:
Mailing address:
  • Phone: 773-406-0930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.040849
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL89990
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: