Individual
SHELLY FERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
5 KISH HOSPITAL DR STE 203, DEKALB, IL 60115-9602
(815) 748-6071
(630) 938-2679
Mailing address
5 KISH HOSPITAL DR STE 203, DEKALB, IL 60115-9602
(815) 748-6071
(630) 938-2679
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209022615
IL
Other
Enumeration date
12/31/2020
Last updated
04/11/2024
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