Provider Demographics
NPI:1881213411
Name:WEBER, SHERYL (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:WEBER
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 1:11601 N 200 E
Mailing Address - Street 2:
Mailing Address - City:DEMOTTE
Mailing Address - State:IN
Mailing Address - Zip Code:46310-9642
Mailing Address - Country:US
Mailing Address - Phone:708-705-1561
Mailing Address - Fax:
Practice Address - Street 1:129 E 107TH AVE
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-6517
Practice Address - Country:US
Practice Address - Phone:219-662-4134
Practice Address - Fax:219-440-7350
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019553363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily