Provider Demographics
NPI:1477679710
Name:HANEY, SHARON LEE (RN, CNM)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:HANEY
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:545 PLAINFIELD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7600
Mailing Address - Country:US
Mailing Address - Phone:630-654-2229
Mailing Address - Fax:630-655-3270
Practice Address - Street 1:545 PLAINFIELD RD
Practice Address - Street 2:SUITE C
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7600
Practice Address - Country:US
Practice Address - Phone:630-654-2229
Practice Address - Fax:630-655-3270
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209000360367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife