Basic Information
| Provider Information | |||||||||
| NPI: | 1972885374 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNEDIKER | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | MORGAN | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 REMINGTON BLVD 100 | ||||||||
| Address2: | |||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604404707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309142468 | ||||||||
| FaxNumber: | 6309142469 | ||||||||
| Practice Location | |||||||||
| Address1: | 1625 SHERIDAN RD | ||||||||
| Address2: | |||||||||
| City: | WILMETTE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600911824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472511500 | ||||||||
| FaxNumber: | 8472512191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2011 | ||||||||
| LastUpdateDate: | 07/09/2015 | ||||||||
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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 | 363LA2200X | 209008895 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.