Provider Demographics
NPI:1326761438
Name:SMITH, SHERRILYNN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRILYNN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6216 W 63RD PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-5012
Mailing Address - Country:US
Mailing Address - Phone:847-309-2233
Mailing Address - Fax:
Practice Address - Street 1:3314 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-4531
Practice Address - Country:US
Practice Address - Phone:708-391-3030
Practice Address - Fax:708-656-4204
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL99999999363LF0000X
IL209026521363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily