Individual
CRYSTAL L SWEENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, NP-C
Contact information
Practice address
2502 E EMPIRE ST, BLOOMINGTON, IL 61704-3738
(309) 663-6461
(309) 663-5711
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209006760
IL
363LF0000X
Family Nurse Practitioner
209006760
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
619710008
MEDICARE PTAN
IL
Enumeration date
09/19/2007
Last updated
01/10/2022
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