Individual
CHERYL ALICIA BAGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2 GOOD SAMARITAN WAY, SUITE 420, MOUNT VERNON, IL 62864-2408
(618) 899-4000
(618) 899-4790
Mailing address
2 GOOD SAMARITAN WAY, SUITE 420, MOUNT VERNON, IL 62864-2408
(618) 899-4000
(618) 899-4790
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85002319
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85002319
LICENSE
IL
01
—
CE9335
RR GROUP
IL
01
—
P00365758
RR NUMBER
IL
Enumeration date
10/16/2006
Last updated
12/01/2020
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