Individual
CHERYL A MACKICHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
611 W PARK ST, ANESTHESIOLOGY, URBANA, IL 61801-2529
(217) 383-3303
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209005190
IL
Other
Enumeration date
11/14/2006
Last updated
05/07/2014
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