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General NPI Number Information
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NPI Number | 1801434733
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Entity Type | Individual
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Provider Name | CHERYL LYNN UPCHURCH PMHNP
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Gender | Female
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 2325 DEAN ST STE 306
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City | ST CHARLES
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State | IL
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Zip | 60175-4810
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Country | US
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Telephone | 630-528-0736
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Fax | 636-764-5997
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Provider Business Mailing Address
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Address Line | 2325 DEAN ST STE 306
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City | ST CHARLES
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State | IL
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Zip | 60175-4810
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Country | US
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Telephone | 630-528-0736
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Fax | 636-764-5997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 277001736
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License Number State | IL
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