Provider Demographics
NPI:1013382019
Name:AREVALO, SHERRY
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:AREVALO
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 1:808 CAROL AVE
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8374
Mailing Address - Country:US
Mailing Address - Phone:815-276-4597
Mailing Address - Fax:
Practice Address - Street 1:808 CAROL AVE
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8374
Practice Address - Country:US
Practice Address - Phone:815-276-4597
Practice Address - Fax:815-271-5457
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter