Provider Demographics
NPI:1699577171
Name:CZERKAS-SHEFFER, LAURA C (RN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:CZERKAS-SHEFFER
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11539 ISABELLA CT
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-8039
Mailing Address - Country:US
Mailing Address - Phone:618-305-3168
Mailing Address - Fax:
Practice Address - Street 1:11539 ISABELLA CT
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-8039
Practice Address - Country:US
Practice Address - Phone:618-305-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041195019261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service