Organization
CHERYL EMMONS MDSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL EMMONS MD (PRESIDENT)
(618) 244-5053
Entity
Organization
Contact information
Practice address
1100 S 42ND ST, SUITE B, MOUNT VERNON, IL 62864-6216
(618) 244-5053
(618) 244-1355
Mailing address
1100 S 42ND ST, SUITE B, MOUNT VERNON, IL 62864-6216
(618) 244-5053
(618) 244-1355
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3485401763
—
IL
01
—
4132016
BCBS OF IL
IL
Enumeration date
04/18/2007
Last updated
08/22/2020
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