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Contact Information

CHERYL CLARK, RN
1604 VISA DR STE 1
NORMAL, IL61761-2195
 Phone: 309-846-4714
 Fax: 309-454-1107
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical-Surgical

163WM0705X
Indicates primary specialty

NPI Profile & details for CHERYL CLARK · (Female)

NPI Number 1558509919
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 01/23/2009
Last updated 01/23/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 041125182
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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