Provider Demographics
NPI:1356643506
Name:SNEEK, DIANA LYNNE (LPN,AAPC,CEO)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:LYNNE
Last Name:SNEEK
Suffix:
Gender:F
Credentials:LPN,AAPC,CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 W MEADOWS DR
Mailing Address - Street 2:#5
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-6739
Mailing Address - Country:US
Mailing Address - Phone:815-232-2182
Mailing Address - Fax:
Practice Address - Street 1:640 FOX KNOLL DR
Practice Address - Street 2:#5
Practice Address - City:LENA
Practice Address - State:IL
Practice Address - Zip Code:61048-9558
Practice Address - Country:US
Practice Address - Phone:815-232-2182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-20
Last Update Date:2010-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043068391164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse