MEDICARE: SEAN MCINERNEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT4463	AR

General Provider Information

NPI Number	:	1144703976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN MCINERNEY

Provider Business Mailing Address
First Line	:	7607 NORTH AVE FRNT
Second Line	:
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-1105
Country	:	US
Telephone Number	:	847-447-3098
Fax Number	:	312-312-9631

Provider Business Practice Location Address
First Line	:	7607 NORTH AVE FRNT
Second Line	:
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-1105
Country	:	US
Telephone Number	:	847-447-3098
Fax Number	:	312-312-9631

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2018
Last Update Date	:	01/21/2026

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Directions to “ SEAN MCINERNEY ” Practice Location

Language	Start Address	Practice Location

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