Provider Demographics
NPI:1225773237
Name:SHEETS, SYDNEY RUTH (PA)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:RUTH
Last Name:SHEETS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:RUTH
Other - Last Name:ISRAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:444 PARKWAY DR APT 442
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-4380
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:444 PARKWAY DR APT 442
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-4380
Practice Address - Country:US
Practice Address - Phone:224-330-5808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant