Provider Demographics
NPI:1942521679
Name:BOCHENEK, SHERRY L
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:L
Last Name:BOCHENEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-7908
Mailing Address - Country:US
Mailing Address - Phone:630-639-1555
Mailing Address - Fax:
Practice Address - Street 1:426 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-7908
Practice Address - Country:US
Practice Address - Phone:630-639-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor