Provider Demographics
NPI:1750827838
Name:TERCHIN, CARLIE RENEE (APN)
Entity Type:Individual
Prefix:
First Name:CARLIE
Middle Name:RENEE
Last Name:TERCHIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:CARLIE
Other - Middle Name:RENEE
Other - Last Name:HILDEBRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:913 VAN BUREN CT
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1356
Mailing Address - Country:US
Mailing Address - Phone:224-875-0901
Mailing Address - Fax:
Practice Address - Street 1:3010 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-2321
Practice Address - Country:US
Practice Address - Phone:847-377-8269
Practice Address - Fax:847-934-5689
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041389293163W00000X
IL209018014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse