Sheri Lynne Banovic, FNP

Individual provider Active NPI Family Nurse Practitioner · Gillespie, IL

NPI 1376765206 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376765206
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
Practice address
115 South Macoupin Street
Gillespie, IL 62033
Phone
(217) 839-1526
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
209000293ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Macoupin County Public Health Department Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X IL Yes

Addresses

Primary practice location

115 South Macoupin Street
Gillespie, IL 62033

Mailing address

520 East Leonard
Staunton, IL 62088-1235
Phone (618) 468-4433

Other providers in Gillespie, IL

All providers in Gillespie, IL · Family Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.