Provider Demographics
NPI:1871196949
Name:GHERNA, CHERYL (RPH)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:GHERNA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 BOHN CIR
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802-4778
Mailing Address - Country:US
Mailing Address - Phone:217-778-9433
Mailing Address - Fax:
Practice Address - Street 1:107 W GREEN ST
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-5282
Practice Address - Country:US
Practice Address - Phone:217-355-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051033319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist