Healthcare Provider Details

I. General information

NPI: 1922009869
Provider Name (Legal Business Name): CHERYL LYNN COMPTON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N 4TH ST
EFFINGHAM IL
62401-3032
US

IV. Provider business mailing address

10731 E HILLTOP PL
EFFINGHAM IL
62401-7417
US

V. Phone/Fax

Practice location:
  • Phone: 217-342-5502
  • Fax: 217-342-6971
Mailing address:
  • Phone: 217-868-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: