Provider Demographics
NPI:1629404298
Name:SWANSON, CYNTHIA KAY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:KAY
Last Name:SWANSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
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Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:847-390-4757
Practice Address - Street 1:1435 N RANDALL RD
Practice Address - Street 2:STE 201
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123
Practice Address - Country:US
Practice Address - Phone:847-695-3168
Practice Address - Fax:847-695-4289
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209.010422363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health