| Doctor Name: | CHERI W KELLY |
| NPI Number: | 1053469387 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 085001319 |
| Business Practice Address: | 7 S Hospital Dr Murphysboro, IL - 629663333 |
| Business Phone Number: | 6186873418 |
| Business Fax Number: | |
| Mailing Address: | Po Box 577, CARTERVILLE |
| State: | IL |
| Postal Code: | 629180577 |
| Phone Number: | 6189569540 |
| Fax Number: | |
| NPI Enumeration Date: | 01/05/2007 |
| NPI Last Update Date: | 09/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 085001319 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |