Healthcare Provider Details
I. General information
NPI: 1568773810
Provider Name (Legal Business Name): RHONDA L SYKES PMHNP-BC, APRN, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/01/2010
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1002 INFANTRY DR STE F
JOLIET IL
60435-3109
US
IV. Provider business mailing address
1002 N 129TH INFANTRY DR STE F
JOLIET IL
60435-3109
US
V. Phone/Fax
- Phone: 815-685-8864
- Fax: 815-823-8460
- Phone: 815-685-8864
- Fax: 815-823-8460
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 6370 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 180003613 |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 209.025372 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: