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General NPI Number Information
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NPI Number | 1144786724
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Entity Type | Individual
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Provider Name | SHEILA ODONNELL NELSON SLP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 1820 WESTERN AVE
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City | NORTHBROOK
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State | IL
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Zip | 60062-6052
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Country | US
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Telephone | 847-400-8738
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Fax |
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Provider Business Mailing Address
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Address Line | 614 E PROSPECT AVE
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City | LAKE BLUFF
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State | IL
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Zip | 60044-2618
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Country | US
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Telephone | 847-791-1058
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Fax |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146002723
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License Number State | IL
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