Provider Demographics
NPI:1265394985
Name:SPERRY, HALLIE (RN)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:
Last Name:SPERRY
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 1:212 S HOLLYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:IL
Mailing Address - Zip Code:61523-2207
Mailing Address - Country:US
Mailing Address - Phone:309-232-2222
Mailing Address - Fax:
Practice Address - Street 1:212 S HOLLYBROOK DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:IL
Practice Address - Zip Code:61523-2207
Practice Address - Country:US
Practice Address - Phone:309-232-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041450289163W00000X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse