Provider Demographics
NPI:1346099462
Name:LEDUC, CHERYL K
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:K
Last Name:LEDUC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18017 S SPRING MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-9003
Mailing Address - Country:US
Mailing Address - Phone:630-258-3200
Mailing Address - Fax:
Practice Address - Street 1:2244 95TH ST STE 219
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8118
Practice Address - Country:US
Practice Address - Phone:708-404-9337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
IL208001284106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist