MEDICARE: MRS. SHEILA M OLOFFSSON M.S., CCC-A

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	231H00000X	Audiologist	147000303	IL

General Provider Information

NPI Number	:	1982953683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEILA M OLOFFSSON M.S., CCC-A

Provider Business Mailing Address
First Line	:	1928 W 102 ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2025
Country	:	US
Telephone Number	:	773-779-8442
Fax Number	:	773-779-7298

Provider Business Practice Location Address
First Line	:	1928 W 102 ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2025
Country	:	US
Telephone Number	:	773-779-8442
Fax Number	:	773-779-7298

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

Provider Enumeration Date	:	09/10/2012
Last Update Date	:	09/10/2012

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Directions to “ MRS. SHEILA M OLOFFSSON M.S., CCC-A” Practice Location

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