Basic Information
| Provider Information | |||||||||
| NPI: | 1639230576 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HENDRICKSON | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7824 DUNHAM | ||||||||
| Address2: | |||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309859982 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | PILLARS 1023 BURLINGTON | ||||||||
| Address2: | |||||||||
| City: | WESTERN SPRINGS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7083540826 | ||||||||
| FaxNumber: | 7083540867 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | IL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.