Healthcare Provider Details

I. General information

NPI: 1437280211
Provider Name (Legal Business Name): LINDA MARIE CHERF C.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date: 01/15/2021
Reactivation Date: 02/09/2021

III. Provider practice location address

3005 S RIVERSIDE DR STE 201
BELOIT WI
53511-1500
US

IV. Provider business mailing address

3005 S RIVERSIDE DR STE 201
BELOIT WI
53511-1500
US

V. Phone/Fax

Practice location:
  • Phone: 608-365-6771
  • Fax: 208-906-2390
Mailing address:
  • Phone: 608-365-6771
  • Fax: 208-906-2390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number357-055
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: