Shannan McNamara, ED. S

Individual provider Active NPI School Psychologist · Village of Lakewood, IL

NPI 1235640996 · NPPES record last updated Oct 20, 2017

Key facts

NPI
1235640996
Entity type
Individual (NPI type 1)
Primary specialty
School Psychologist 103TS0200X
Practice address
8001 Redtail Dr
Village of Lakewood, IL 60014-3354
Phone
(847) 707-1176
NPI assigned
Oct 20, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X Yes

Addresses

Primary practice location

8001 Redtail Dr
Village of Lakewood, IL 60014-3354

Mailing address

8001 Redtail Dr
Village of Lakewood, IL 60014-3354

Other providers in Village of Lakewood, IL

All providers in Village of Lakewood, IL · School Psychologist in Illinois

Sources for this page

Verify at the official NPI Registry.