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1184861742
SHANI M DOUGLAS
TINLEY PARK, IL
NPI
1184861742
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Former Name
SHANI M MCCLELLAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070-013962)
Enumeration Date
2009-01-19
Last Update Date
2009-04-28
Business Address
-- SHANI M DOUGLAS PT, DPT
16651 HARLEM AVE
TINLEY PARK, IL 60477-2581
Phone number: 708-444-2467
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Mailing Address
-- SHANI M DOUGLAS PT, DPT
10421 S WALLACE ST
CHICAGO, IL 60628-2441
Phone number:
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