Provider Demographics
NPI:1548075393
Name:FEENEY, ROSE MAIRE (OTR/L)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:MAIRE
Last Name:FEENEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 E GIROT LN
Mailing Address - Street 2:
Mailing Address - City:DIAMOND
Mailing Address - State:IL
Mailing Address - Zip Code:60416-6200
Mailing Address - Country:US
Mailing Address - Phone:815-953-5941
Mailing Address - Fax:
Practice Address - Street 1:724 E VETERANS PKWY STE B
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1889
Practice Address - Country:US
Practice Address - Phone:630-553-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.016440225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist