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General NPI Number Information
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NPI Number | 1144204504
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Entity Type | Individual
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Provider Name | PATRICK J SWEENEY MD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 19110 DARVIN DR STE C
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City | MOKENA
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State | IL
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Zip | 60448-8595
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Country | US
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Telephone | 708-390-2290
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Fax | 708-390-2299
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Provider Business Mailing Address
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Address Line | 19110 DARVIN DR STE C
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City | MOKENA
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State | IL
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Zip | 60448-8595
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Country | US
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Telephone | 708-390-2290
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Fax | 708-390-2299
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 036 085125
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 01042908A
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License Number State | IN
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