Individual
ANGIE M EUBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
5383 STATE ROUTE 154, PINCKNEYVILLE, IL 62274-3342
(618) 357-2131
(618) 357-8844
Mailing address
5383 STATE ROUTE 154, PINCKNEYVILLE, IL 62274-3342
(618) 357-2131
(618) 357-8844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-000595
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07320380
BCBS
IL
01
—
342557
HEALTHLINK
IL
05
—
376006955007
—
IL
01
—
970020589
MEDICARE RAILROAD
IL
Enumeration date
04/14/2006
Last updated
07/10/2023
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