Provider Demographics
NPI:1336379882
Name:BRESNAHAN, SHERRY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:LYNN
Last Name:BRESNAHAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 HIAWATHA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-1421
Mailing Address - Country:US
Mailing Address - Phone:847-658-5828
Mailing Address - Fax:847-658-5861
Practice Address - Street 1:330 HIAWATHA DR
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-1421
Practice Address - Country:US
Practice Address - Phone:847-658-5828
Practice Address - Fax:847-658-5861
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor