Provider Demographics
NPI:1609987148
Name:SYKES, PAMELA RUTH (APRN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:RUTH
Last Name:SYKES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-3065
Mailing Address - Country:US
Mailing Address - Phone:847-735-9638
Mailing Address - Fax:
Practice Address - Street 1:3001 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3048
Practice Address - Country:US
Practice Address - Phone:847-688-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-11-10
Deactivation Date:2020-10-27
Deactivation Code:
Reactivation Date:2020-11-10
Provider Licenses
StateLicense IDTaxonomies
WI12173630363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health