Provider Demographics
NPI:1427325208
Name:CASEY, SHARON ANN (RN, MN, ANP-BC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:CASEY
Suffix:
Gender:F
Credentials:RN, MN, ANP-BC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ANN
Other - Last Name:CRANDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MN
Mailing Address - Street 1:155 E BRUSH HILL RD
Mailing Address - Street 2:B3204
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5658
Mailing Address - Country:US
Mailing Address - Phone:331-221-0288
Mailing Address - Fax:331-221-3851
Practice Address - Street 1:155 E BRUSH HILL RD
Practice Address - Street 2:B3204
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5658
Practice Address - Country:US
Practice Address - Phone:331-221-0288
Practice Address - Fax:331-221-3851
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.002915041.235644363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health