Individual
MRS. MEGAN M SKOLASINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
414 S STATE ST, ROODHOUSE, IL 62082-1544
(217) 589-4383
(217) 589-4409
Mailing address
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
(618) 498-7518
(618) 498-3052
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004837
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085004837
PROVIDER LICENSE
IL
Enumeration date
09/25/2013
Last updated
11/13/2024
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