Basic Information
| Provider Information | |||||||||
| NPI: | 1700266848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALOMO | ||||||||
| FirstName: | CHERRY | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4309 W MEDICAL CENTER DR | ||||||||
| Address2: | MOB A102- HOSPITALIST OFFICE | ||||||||
| City: | MCHENRY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600508419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157594323 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4309 W MEDICAL CENTER DR | ||||||||
| Address2: | MOB A102- HOSPITALIST OFFICE | ||||||||
| City: | MCHENRY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600508419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157594323 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2015 | ||||||||
| LastUpdateDate: | 08/08/2017 | ||||||||
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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 | 363L00000X | 209012666 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.