Individual
MS. CHERYL LYNN SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4101 W ILES AVE, SPRINGFIELD, IL 62711-7051
(217) 793-9429
(217) 993-7090
Mailing address
CONCORDIA VILLAGE, 4101 W. ILES, SPRINGFIELD, IL 62704
(217) 793-9429
(217) 993-7090
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.061514
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043.061514
043.061514
IL
Enumeration date
08/23/2021
Last updated
08/23/2021
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