Provider Demographics
NPI:1063103547
Name:ABENDROTH, CASSIE ANN (APRN)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:ANN
Last Name:ABENDROTH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2683 N 1800 ST
Mailing Address - Street 2:
Mailing Address - City:BEECHER CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62414-2543
Mailing Address - Country:US
Mailing Address - Phone:618-780-9301
Mailing Address - Fax:
Practice Address - Street 1:415 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62565-1245
Practice Address - Country:US
Practice Address - Phone:217-774-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.027442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily