Provider Demographics
NPI:1508823022
Name:MEANS, CHERYL (COTA/L)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:MEANS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 502
Mailing Address - Street 2:
Mailing Address - City:CISNE
Mailing Address - State:IL
Mailing Address - Zip Code:62823-0502
Mailing Address - Country:US
Mailing Address - Phone:618-673-2539
Mailing Address - Fax:
Practice Address - Street 1:1303 W EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-1619
Practice Address - Country:US
Practice Address - Phone:217-342-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant