Provider Demographics
NPI:1023382199
Name:CHRISMAN, SHERRY (BA, CADC, MISA I)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:CHRISMAN
Suffix:
Gender:F
Credentials:BA, CADC, MISA I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 US HIGHWAY 45 N
Mailing Address - Street 2:
Mailing Address - City:ELDORADO
Mailing Address - State:IL
Mailing Address - Zip Code:62930-3766
Mailing Address - Country:US
Mailing Address - Phone:618-273-3326
Mailing Address - Fax:618-273-3585
Practice Address - Street 1:1412 US HIGHWAY 45 N
Practice Address - Street 2:
Practice Address - City:ELDORADO
Practice Address - State:IL
Practice Address - Zip Code:62930-3766
Practice Address - Country:US
Practice Address - Phone:618-273-3326
Practice Address - Fax:618-273-3585
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)