Provider Demographics
NPI:1568605988
Name:MCINTOSH, CHERYL L (PT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT CH 14389
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-4389
Mailing Address - Country:US
Mailing Address - Phone:785-295-5307
Mailing Address - Fax:785-231-5991
Practice Address - Street 1:601 SW CORPORATE VW
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1244
Practice Address - Country:US
Practice Address - Phone:785-270-7674
Practice Address - Fax:785-273-0716
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1102329208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation