MEDICARE: SHARON S CORRIGAN OT

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	225X00000X	Occupational Therapist	056001776	IL

General Provider Information

NPI Number	:	1437376886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON S CORRIGAN OT

Provider Business Mailing Address
First Line	:	625 ENTERPRISE DR.
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-8813
Country	:	US
Telephone Number	:	630-575-6250
Fax Number	:	630-575-7450

Provider Business Practice Location Address
First Line	:	4412 S PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-4011
Country	:	US
Telephone Number	:	773-847-3123
Fax Number	:	773-847-3778

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	06/15/2017

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