Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | IL |
NPI | 1073690319 |
---|---|
Provider Name | Sheila M. Lajeune |
First Address | Chicago, IL 60661-5500 |
Second Address | Chicago, IL 60646-6153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |