Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209005750 | IL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 209005750 | IL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 309.003039 | IL |
NPI | 1558308940 |
---|---|
Provider Name | Ms. Michele Cheever |
First Address | Normal, IL 61761-3551 |
Second Address | Normal, IL 61761-3551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 14/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05732097 | BC GROUP NUMBER (01) | IL |
112165 | HEALTH ALLIANCE (01) | IL |
Q68111 | (02) | IL |