Individual
DR. KATHLEEN V SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
42258 N CRAWFORD RD, A-1, ANTIOCH, IL 60002-9570
(847) 217-7660
(847) 395-9973
Mailing address
42258 N CRAWFORD RD, A-1, ANTIOCH, IL 60002-9570
(847) 217-7660
(847) 395-9973
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003133
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0497205371
BCBS
IL
Enumeration date
09/27/2006
Last updated
07/18/2012
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