MEDICARE: SHERRY L MEWES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209016573	IL

General Provider Information

NPI Number	:	1518476191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY L MEWES

Provider Business Mailing Address
First Line	:	213 NW 10TH ST STE A
Second Line	:
City	:	FAIRFIELD
State	:	IL
Zip	:	62837-1219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 NW 10TH ST STE A
Second Line	:
City	:	FAIRFIELD
State	:	IL
Zip	:	62837-1219
Country	:	US
Telephone Number	:	618-842-4617
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2017
Last Update Date	:	09/26/2017

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Directions to “ SHERRY L MEWES ” Practice Location

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