Provider Demographics
NPI:1992171326
Name:HAMMOND, CYNTHIA (NP-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7312 S CLYDE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-3109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1701 W MONTEREY AVE
Practice Address - Street 2:#7
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4257
Practice Address - Country:US
Practice Address - Phone:872-806-0397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013119363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily