Cheryl Dement, PT

Individual provider Active NPI Physical Therapist · Clinton, IL

NPI 1629026604 · NPPES record last updated Apr 20, 2011

Key facts

NPI
1629026604
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070-008331 (IL)
Practice address
215 W White St
Clinton, IL 61727-2240
Phone
(217) 937-5224
Fax
(217) 937-5360
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
070-008331ILMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-008331 IL Yes

Addresses

Primary practice location

215 W White St
Clinton, IL 61727-2240

Mailing address

PO Box 5387
Bloomington, IL 61702-5387
Phone (309) 661-8823

Other identifiers

IdentifierTypeStateIssuer
070-008331OtherILIL LICENSE NO

Other providers in Clinton, IL

All providers in Clinton, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.