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NPI 1497675953

NPI 1497675953 : SHERRICE NICOLE CLINTON : BERWYN, IL

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General NPI Number Information
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    NPI Number           |    1497675953
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    Entity Type          |    Individual 
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    Provider Name        |    SHERRICE NICOLE CLINTON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/16/2026
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    Last Update Date     |    07/16/2026
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Provider Practice Location Address
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    Address Line         |    3551 EUCLID AVE 
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    City                 |    BERWYN
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    State                |    IL
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    Zip                  |    60402-3662
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    Country              |    US
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    Telephone            |    312-889-8979
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3551 EUCLID AVE 
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    City                 |    BERWYN
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    State                |    IL
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    Zip                  |    60402-3662
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    Country              |    US
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    Telephone            |    312-889-8979
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163WM0705X
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    Taxonomy Name        |    Medical-Surgical Registered Nurse
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    License Number       |    041382343
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    License Number State |    IL
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