Cheryl E Connolly, LMT
Individual provider Active NPI Massage Therapist · Cobden, IL
NPI 1457783227 · NPPES record last updated Aug 5, 2013
Key facts
- NPI
- 1457783227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227.006160 (IL)
- Practice address
- 111 S. Appleknocker St.
Cobden, IL 62920-2326 - Phone
- (618) 559-6302
- NPI assigned
- Aug 5, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227.006160 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227.006160 | IL | Yes |
Addresses
Primary practice location
111 S. Appleknocker St.
Cobden, IL 62920-2326
Mailing address
605 Skyline Dr
Cobden, IL 62920-2123
Phone (618) 559-6302
Other providers in Cobden, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.