Provider Demographics
NPI:1801434733
Name:UPCHURCH, CHERYL LYNN (PMHNP)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LYNN
Last Name:UPCHURCH
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:LYNN
Other - Last Name:ISCHAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:2325 DEAN ST STE 306
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-4810
Mailing Address - Country:US
Mailing Address - Phone:630-528-0736
Mailing Address - Fax:636-764-5997
Practice Address - Street 1:2325 DEAN ST STE 306
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-4810
Practice Address - Country:US
Practice Address - Phone:630-528-0736
Practice Address - Fax:636-764-5997
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277001736363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health