Provider Demographics
NPI:1912526278
Name:CARDWELL, SHARI LYNN (APN)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:LYNN
Last Name:CARDWELL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 DOVERCLIFF WAY
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-1803
Mailing Address - Country:US
Mailing Address - Phone:847-757-6561
Mailing Address - Fax:
Practice Address - Street 1:1125 DOVERCLIFF WAY
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1803
Practice Address - Country:US
Practice Address - Phone:847-757-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041377549163WC0200X
IL209020696363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine