Provider Demographics
NPI:1902391105
Name:ISETTS, CYNTHIA (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ISETTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E ARMY TRAIL RD STE 301
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2152
Mailing Address - Country:US
Mailing Address - Phone:630-893-0347
Mailing Address - Fax:630-893-1467
Practice Address - Street 1:303 E ARMY TRAIL RD STE 301
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2152
Practice Address - Country:US
Practice Address - Phone:630-893-0347
Practice Address - Fax:630-893-1467
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041428436163W00000X
IL209.024934363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse