CHERI W KELLY PA
NPI 1053469387
Physician Assistant - Medical in Murphysboro, IL

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

Active since January 05, 2007

7 S HOSPITAL DR, MURPHYSBORO, IL 62966(618) 687-3418 Get Directions Write a Review

NPPES record last updated: September 13, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Cheri W Kelly Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHERI W KELLY PA (NPI 1053469387) is an individual medical provider in Murphysboro, Illinois, licensed in Illinois (085001319) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1053469387

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameCHERI W KELLYCredential: PA

Location Address7 S HOSPITAL DRMurphysboro, IL 62966-3333

Mailing AddressPo Box 577Carterville, IL 62918-0577 · (618) 956-9540

Phone(618) 687-3418

Sole ProprietorNo

Enumeration DateJanuary 5, 2007

Last NPPES UpdateSeptember 13, 2012

✔ NPI 1053469387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in IL · 085001319

7 S HOSPITAL DR, Murphysboro, IL 62966

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Other Identifiers 9

Other085001319IL · State License Number

Medicare OSCAR/certification141840IL

OtherCF3444IL · Medicare Rr

Medicare OSCAR/certification640701IL

Medicare UPINS97504IL

Medicare OSCAR/certification141848IL

Medicaid370966854002IL

Medicaid370966854005IL

Other132564IL · Health Alliance

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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