Provider Demographics
NPI:1801165436
Name:GIESE, SHERYL (APRN, CNP)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:GIESE
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N WESTMORELAND RD STE 223
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1694
Mailing Address - Country:US
Mailing Address - Phone:847-535-7830
Mailing Address - Fax:847-535-7875
Practice Address - Street 1:900 N WESTMORELAND RD STE 223
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1694
Practice Address - Country:US
Practice Address - Phone:847-535-7830
Practice Address - Fax:847-535-7875
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018445363LA2100X, 363L00000X
IL041325860163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse