Provider Demographics
NPI:1619519790
Name:KOCHUPARAMBIL SEBASTIAN, SILVIYA (DNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SILVIYA
Middle Name:
Last Name:KOCHUPARAMBIL SEBASTIAN
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 W 65TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-3165
Mailing Address - Country:US
Mailing Address - Phone:901-359-0057
Mailing Address - Fax:
Practice Address - Street 1:38 W 65TH ST APT 3
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-3165
Practice Address - Country:US
Practice Address - Phone:901-359-0057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041367958163W00000X
IL209024150363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse