Provider Demographics
NPI:1396728051
Name:MCNEIL, SEAN MICHAEL (ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:MICHAEL
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 ADAMS ST
Mailing Address - Street 2:UNIT GW
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1334
Mailing Address - Country:US
Mailing Address - Phone:773-329-3932
Mailing Address - Fax:
Practice Address - Street 1:820 N LASALLE ST
Practice Address - Street 2:SOLHEIM CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-3214
Practice Address - Country:US
Practice Address - Phone:312-329-2252
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer