Provider Demographics
NPI:1194157263
Name:CHERY, LACHANDA (LMT)
Entity type:Individual
Prefix:MS
First Name:LACHANDA
Middle Name:
Last Name:CHERY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:LACHANDA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1485 FAIRWAY DR
Mailing Address - Street 2:#302
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9404
Mailing Address - Country:US
Mailing Address - Phone:630-809-1930
Mailing Address - Fax:
Practice Address - Street 1:1485 FAIRWAY DR
Practice Address - Street 2:#302
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9404
Practice Address - Country:US
Practice Address - Phone:630-809-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.014691225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist