Provider Demographics
NPI:1962481770
Name:PILKINGTON, SHERRY L (NP)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:L
Last Name:PILKINGTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:916 TALON DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1848
Mailing Address - Country:US
Mailing Address - Phone:618-628-8211
Mailing Address - Fax:618-628-0883
Practice Address - Street 1:916 TALON DR
Practice Address - Street 2:SUITE 102
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1848
Practice Address - Country:US
Practice Address - Phone:618-628-8211
Practice Address - Fax:618-628-0883
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08220357OtherBCBS OF IL GRP#
IL08220357OtherBCBS OF IL GRP#
ILS45440Medicare UPIN