Provider Demographics
NPI:1902070196
Name:KILLEN, CHERYL A (RN)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:KILLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W JOHN STREET
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-9249
Mailing Address - Country:US
Mailing Address - Phone:630-553-9100
Mailing Address - Fax:630-553-9604
Practice Address - Street 1:811 W JOHN STREET
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-9249
Practice Address - Country:US
Practice Address - Phone:630-553-9100
Practice Address - Fax:630-553-9604
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse