Provider Demographics
NPI:1851178008
Name:VODNIK, SHERI
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:VODNIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14421 S WALLIN DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2502
Mailing Address - Country:US
Mailing Address - Phone:630-402-6060
Mailing Address - Fax:
Practice Address - Street 1:14421 S WALLIN DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2502
Practice Address - Country:US
Practice Address - Phone:630-402-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty