Provider Demographics
NPI:1477918613
Name:BURCENSKI, SHERYL (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:
Last Name:BURCENSKI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MADISON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6549
Mailing Address - Country:US
Mailing Address - Phone:815-725-4367
Mailing Address - Fax:815-725-4863
Practice Address - Street 1:301 MADISON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6549
Practice Address - Country:US
Practice Address - Phone:815-725-4367
Practice Address - Fax:815-725-4863
Is Sole Proprietor?:No
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily