Provider Demographics
NPI:1366738585
Name:STERRICKER-RYDELL, JEANNE (APN, NP-C)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:STERRICKER-RYDELL
Suffix:
Gender:F
Credentials:APN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-3315
Mailing Address - Country:US
Mailing Address - Phone:847-697-9100
Mailing Address - Fax:847-697-5105
Practice Address - Street 1:552 RANDALL RD
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-3315
Practice Address - Country:US
Practice Address - Phone:847-697-9100
Practice Address - Fax:847-697-5105
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008712363LF0000X
COAPN.0991735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400183338OtherMEDICARE PTAN (INDIVIDUAL)
IL920540OtherMEDICARE PTAN (GROUP)
IL920540OtherMEDICARE PTAN (GROUP)