Provider Demographics
NPI:1043296023
Name:RUSHING, CHERYL JEANNE UY (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL JEANNE
Middle Name:UY
Last Name:RUSHING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CHERYL JEANNE
Other - Middle Name:YU
Other - Last Name:UY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2205 DAKOTA LN
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62801-8751
Mailing Address - Country:US
Mailing Address - Phone:618-292-2334
Mailing Address - Fax:
Practice Address - Street 1:8 DOCTORS PARK RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6224
Practice Address - Country:US
Practice Address - Phone:618-241-8595
Practice Address - Fax:618-241-8759
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL70013948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL70013948OtherPT LICENSE