Provider Demographics
NPI:1740451236
Name:PYTEL, SHARON (NP-C)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:PYTEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4200
Mailing Address - Country:US
Mailing Address - Phone:630-208-4460
Mailing Address - Fax:630-208-4338
Practice Address - Street 1:351 DELNOR DR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4222
Practice Address - Country:US
Practice Address - Phone:630-938-9600
Practice Address - Fax:630-933-7839
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006950363L00000X
IL209.006950363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL260147OtherMEDICARE PTAN (GROUP)
IL04515143OtherBCBS#
ILF400183971OtherMEDICARE PTAN (INDIVIDUAL)
IL260147OtherMEDICARE PTAN (GROUP)
IL576550001Medicare PIN
IL207710003Medicare PIN