Provider Demographics
NPI:1669620480
Name:KERBER, CYNTHIA HODSON (PHD, APRN, BC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:HODSON
Last Name:KERBER
Suffix:
Gender:F
Credentials:PHD, APRN, BC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:HODSON
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, APRN, BC
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5709
Mailing Address - Country:US
Mailing Address - Phone:309-438-8258
Mailing Address - Fax:
Practice Address - Street 1:1 WESTBROOK CORPORATE CTR STE 300
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5709
Practice Address - Country:US
Practice Address - Phone:877-906-9699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-004560364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209-004560OtherADVANCED PRACTICE NURSE LICENSE