Provider Demographics
NPI:1538149273
Name:OCKERLANDER, SHARON ANN (MSW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:OCKERLANDER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 S PHELPS AVE
Mailing Address - Street 2:SUITE 516
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2453
Mailing Address - Country:US
Mailing Address - Phone:815-229-7301
Mailing Address - Fax:815-229-7302
Practice Address - Street 1:129 S PHELPS AVE
Practice Address - Street 2:SUITE 516
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2453
Practice Address - Country:US
Practice Address - Phone:815-229-7301
Practice Address - Fax:815-229-7302
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILR21861Medicare UPIN