Provider Demographics
NPI:1417725300
Name:WETZKER, CHERYL ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:WETZKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BLANCHARD CIR STE 106
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2047
Mailing Address - Country:US
Mailing Address - Phone:630-668-5985
Mailing Address - Fax:630-580-7324
Practice Address - Street 1:7 BLANCHARD CIR STE 106
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-2047
Practice Address - Country:US
Practice Address - Phone:630-668-5985
Practice Address - Fax:630-580-7324
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.029084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily