Individual
CHEYENNE RENEE DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1047 CENTURY DR, EDWARDSVILLE, IL 62025-3772
(618) 307-3434
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225X00000X
Occupational Therapist
Primary
056015934
IL
Other
Enumeration date
10/09/2018
Last updated
03/12/2024
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