Individual provider Active NPI

Cheryl Marie Cline

  • Speech-Language Pathologist
  • East Peoria, IL
National Provider Identifier
1497273908
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146003185 Issued in IL
Practice address
119 Eastwood Dr
East Peoria, IL 61611-1585
Phone
(309) 645-4879
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146003185 IL Primary

Addresses

Primary practice location

119 Eastwood Dr
East Peoria, IL 61611-1585

Mailing address

119 Eastwood Dr
East Peoria, IL 61611-1585
Phone (309) 645-4879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
146003185ILMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497273908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 EASTWOOD DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111585",
            "telephone_number": "309-645-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 EASTWOOD DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111585",
            "telephone_number": "309-645-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINE",
        "first_name": "CHERYL",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146003185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.