Provider Demographics
NPI:1043876683
Name:ONEILL, CYNTHIA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:ONEILL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:AHERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-0096
Mailing Address - Country:US
Mailing Address - Phone:708-429-3455
Mailing Address - Fax:
Practice Address - Street 1:6850 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1653
Practice Address - Country:US
Practice Address - Phone:708-429-3455
Practice Address - Fax:708-429-3422
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-18
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.018922363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner