Individual
MRS. DENISE O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
805 CHAFFEE LN, NEW LENOX, IL 60451-3467
(708) 305-2384
(815) 462-9093
Mailing address
805 CHAFFEE LN, NEW LENOX, IL 60451-3467
(815) 462-9093
(815) 462-9093
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009932330
BLUE CROSS BLUE SHIELD
—
01
—
DO13461099P
EARLY INTERVENTION IDHS
IL
Enumeration date
01/13/2007
Last updated
07/08/2007
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