Individual
CHERYL MANGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-5332
(217) 366-6106
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1326
(217) 366-6106
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-002934
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
433990
MEDICARE GROUP
—
01
—
500008011
RAILROAD MEDICARE
—
Enumeration date
08/01/2006
Last updated
09/23/2013
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