Individual
DARLENE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13245 KESSLER RD, CAIRO, IL 62914-3101
(618) 734-4400
(618) 477-8557
Mailing address
PO BOX 3008, CARBONDALE, IL 62902-3008
(618) 734-4400
(618) 477-8557
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27891
ILLINOIS CERTIFICATION BOARD
IL
Enumeration date
04/29/2019
Last updated
06/11/2019
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