Healthcare Provider Details

I. General information

NPI: 1649819178
Provider Name (Legal Business Name): CHERYL A LEMAN APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2020
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 W JACKSON ST
MORTON IL
61550-1569
US

IV. Provider business mailing address

2719 ARROWHEAD DR
BLOOMINGTON IL
61704-8161
US

V. Phone/Fax

Practice location:
  • Phone: 309-308-5100
  • Fax: 309-308-5119
Mailing address:
  • Phone: 309-242-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277002293
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: