Provider Demographics
NPI:1588714315
Name:NEWCOMB, SHEILA M (PT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14234 S BELL RD
Mailing Address - Street 2:PMB 143
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60491-8122
Mailing Address - Country:US
Mailing Address - Phone:708-301-7981
Mailing Address - Fax:708-301-6765
Practice Address - Street 1:14234 S BELL RD
Practice Address - Street 2:PMB 143
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60491-8122
Practice Address - Country:US
Practice Address - Phone:708-301-7981
Practice Address - Fax:708-301-6765
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics