Provider Demographics
NPI:1194780718
Name:O'NEAL, PATRICIA RENEE (BA, MS)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:RENEE
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:BA, MS
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:RENEE
Other - Last Name:BURWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3248 VANDEVER
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554
Mailing Address - Country:US
Mailing Address - Phone:309-347-5579
Mailing Address - Fax:309-347-7302
Practice Address - Street 1:3248 VANDEVER
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554
Practice Address - Country:US
Practice Address - Phone:309-347-5579
Practice Address - Fax:309-347-7302
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health